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Risk of disseminated intravascular coagulation in patients with type 2 diabetes mellitus: retrospective cohort study
  1. Kenichiro Nogami1,2,
  2. Isao Muraki1,3,
  3. Hironori Imano1,
  4. Hiroyasu Iso1
  1. 1Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
  2. 2Takeda Development Center Japan, Takeda Pharmaceutical Company Limited, Osaka, Japan
  3. 3Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
  1. Correspondence to Kenichiro Nogami; kenichiro_nogami{at}


Objectives To determine quantitatively the association between type 2 diabetes mellitus (T2DM) and disseminated intravascular coagulation (DIC).

Design Retrospective cohort study using a claims database.

Setting Medical care institutions representing 9% of all secondary hospitals (acute care hospitals) in Japan.

Participants In total, 797 324 admissions, comprising 435 354 patients aged 18–79 years at the time of admission, were enrolled between January 2010 and September 2014. All patients were diagnosed with diabetes or admitted to hospitals that provided laboratory data.

Main outcome measures Incidence of DIC reported by physicians in claims data.

Results Logistic regression analysis found that the risk of DIC was significantly higher in T2DM patients than in non-DM patients (fully adjusted OR: 1.39 (95% CI 1.32 to 1.45)), independent of age, sex, admission year and potential underlying diseases. The higher risk of DIC in T2DM patients was apparent in those who were treated with insulin within the 30-day period prior to admission (1.53 (1.37 to 1.72)). When stratified by the potential underlying diseases, the risk of DIC was higher in T2DM patients with non-septic severe infection (1.67 (1.41 to 1.97)) and with solid tumour (1.59 (1.47 to 1.72)) than in non-DM patients with those underlying diseases. The risk was similar between T2DM and non-DM patients with sepsis (0.98 (0.90 to 1.08)) and lower in T2DM patients with acute leukaemia (0.70 (0.59 to 0.84)).

Conclusions T2DM was associated with a higher risk of DIC, particularly when recently treated with insulin, as well as among admissions with solid tumour or non-septic severe infection.

  • type 2 diabetes mellitus
  • disseminated intravascular coagulation
  • anti-diabetics

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  • Contributors KN and IM designed the study, performed statistical analysis and drafted the manuscript. IM and H Iso provided statistical expertise. All authors contributed to the interpretation of the data and the critical revision of the manuscript and approved the final version. KN, IM and H Iso are the guarantors of the current investigation.

  • Funding This study was conducted using the data from MDV purchased by the Takeda Pharmaceutical Company by which the lead author, KN, was employed.

  • Competing interests KN received salary from the Takeda Pharmaceutical Company.

  • Ethics approval The present study was approved by the Ethics Committee of the Graduate School of Medicine/Faculty of Medicine, Osaka University (approval number 16090).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Transparency declaration The lead author affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained.

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