Achilles or biceps tendon rupture in women and men with type 2 diabetes: A population-based case-control study

J Diabetes Complications. 2016 Jul;30(5):903-9. doi: 10.1016/j.jdiacomp.2016.02.017. Epub 2016 Feb 23.

Abstract

Aims: Previous studies suggest that diabetes causes alterations in tendon collagen structure, but evidence on how such findings translate into clinical practice is scarce. We aimed to analyze the association between type 2 diabetes and the risk of tendon rupture.

Materials and methods: We conducted a matched case-control analysis using the UK-based Clinical Practice Research Datalink. Cases (n=7895) were aged 30-89years and had an incident diagnosis of Achilles- or biceps tendon rupture between 1995 and 2013. In multivariable logistic regression analyses we compared the odds of tendon rupture between patients with or without type 2 diabetes, in men and women separately, and taking into account diabetes severity (HbA1c), duration, and antidiabetic drug treatment.

Results: Within 165 (7.1%) female cases with type 2 diabetes, odds ratios (ORs) were increased with poorer diabetes control (OR 2.03, 95% CI 1.20-3.41, HbA1c ≥9% [≥75mmol/mol]), longer disease duration (OR 1.60, 95% CI 0.93-2.74, ≥10years), and current insulin use (OR 2.25, 95% CI 1.30-3.90, ≥20 prescriptions). Among 372 (6.7%) male cases, there was no effect of type 2 diabetes on the risk of tendon rupture.

Conclusions: Our results suggest that the risk of tendon ruptures may be increased in women with poorly controlled type 2 diabetes, but not in men.

Keywords: Case control; Clinical Practice Research Datalink; Observational; Tendon rupture; Type 2 diabetes.

Publication types

  • Observational Study

MeSH terms

  • Achilles Tendon / injuries*
  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Female
  • Glycated Hemoglobin A / analysis
  • Hamstring Tendons / injuries*
  • Humans
  • Hyperglycemia / prevention & control*
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Incidence
  • Insulin / adverse effects
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Primary Health Care
  • Retrospective Studies
  • Risk
  • Rupture / chemically induced
  • Rupture / complications*
  • Rupture / epidemiology
  • Rupture / prevention & control
  • Sex Factors
  • United Kingdom / epidemiology

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human