PT - JOURNAL ARTICLE AU - Joshua P. Entrop AU - Susanna Kullberg AU - Johan Grunewald AU - Anders Eklund AU - Kerstin Brismar AU - Elizabeth V. Arkema TI - Type 2 diabetes risk in sarcoidosis patients untreated and treated with corticosteroids AID - 10.1183/23120541.00028-2021 DP - 2021 Apr 01 TA - ERJ Open Research PG - 00028-2021 VI - 7 IP - 2 4099 - http://openres.ersjournals.com/content/7/2/00028-2021.short 4100 - http://openres.ersjournals.com/content/7/2/00028-2021.full SO - erjor2021 Apr 01; 7 AB - Background The rate of type 2 diabetes mellitus (T2D) is increased in sarcoidosis patients but it is unknown if corticosteroid treatment plays a role. We investigated whether the T2D risk is higher in untreated and corticosteroid-treated sarcoidosis patients compared with the general population.Methods In this cohort study, individuals with two or more International Statistical Classification of Diseases and Related Health Problems (ICD) codes for sarcoidosis were identified from the Swedish National Patient Register (NPR) (n=5754). Corticosteroid dispensations within 3 months before or after the first sarcoidosis diagnosis were identified from the Swedish Prescribed Drug Register (PDR). General population comparators without sarcoidosis were matched to cases 10:1 on age, sex and region of residence (n=61 297). Incident T2D was identified using ICD codes (NPR) and antidiabetic drug dispensations (PDR). Follow-up was from the second sarcoidosis diagnosis/matching date until T2D, emigration, death or study end (December 2013). Cox regression models adjusted for age, sex, education, country of birth, healthcare regions and family history of diabetes were used to estimate hazard ratios (HRs). We used flexible parametric models to examine the T2D risk over time.Results 40% of sarcoidosis patients were treated with corticosteroid at diagnosis. The T2D rate was 7.7 per 1000 person-years in untreated sarcoidosis, 12.7 per 1000 person-years in corticosteroid-treated sarcoidosis and 5.5 per 1000 person-years in comparators. The HR for T2D was 1.4 (95% CI 1.2–1.8) associated with untreated sarcoidosis and 2.3 (95% CI 2.0–3.0) associated with corticosteroid-treated sarcoidosis. The T2D risk was highest for corticosteroid-treated sarcoidosis in the first 2 years after diagnosis.Conclusions Sarcoidosis is associated with an increased risk of T2D especially in older, male, corticosteroid-treated patients at diagnosis. Screening for T2D for these patients is advisable.Corticosteroid-treated sarcoidosis patients have a high risk of developing type 2 diabetes within 2 years after their sarcoidosis diagnosis. The risk is higher for male and older patients compared with female and younger patients. https://bit.ly/3l6mkXM