Psoriasis May Offer Clues About Type 2 Diabetes Risk

Patients with severe psoriasis were 64% more likely to develop diabetes than control patients.

Inflammation is involved with numerous conditions and adverse events, including heart disease. A new study suggests that an inflammatory condition of the skin may modify the risk for diabetes.

Patients with psoriasis may be at a higher risk of developing type 2 diabetes, with the risk increasing in line with disease severity, according to a study published by the Journal of the American Academy of Dermatology.

The authors discovered that patients with psoriasis covering at least 10% of their body were 64% more likely to develop diabetes compared with patients without psoriasis. These findings remained true after accounting for diabetes risk factors, such as weight.

If applicable to the global population, the authors project that there would be more than 125,650 new cases of diabetes related to psoriasis each year, according to the study.

“The type of inflammation seen in psoriasis is known to promote insulin resistance, and psoriasis and diabetes share similar genetic mutations suggesting a biological basis for the connection between the two conditions we found in our study,” said senior author Joel M. Gelfand, MD MSCE. “We know psoriasis is linked to higher rates of diabetes, but this is the first study to specifically examine how the severity of the disease affects a patient’s risk.”

In the study, the authors measured body surface area (BSA) to determine psoriasis severity among 8124 adults with psoriasis and 76,599 adults without psoriasis over 4 years. The authors accounted for differences in age, sex, weight, and other diabetes risk factors.

Patients with a BAS of 2% or less were 21% more likely to develop diabetes than patients without diabetes, according to the study.

The authors also discovered that the risk of diabetes skyrocketed among patients with a BSA of 10% or higher. Among these patients, 12.22 per 1000 patients will develop diabetes compared with 5.97 out of every 1000 for the general population, according to the study.

Overall, these patients were 64% more likely to develop diabetes than control patients, with each 10% increase in BSA associated with an increased risk of 20%.

The authors said that BSA should be monitored in patients with psoriasis. These results also suggest that patients with psoriasis—especially those with a BSA of over 10%—should receive preventive services.

“These findings are independent of traditional risk factors for diabetes and still show a strong connection between the increasing severity of psoriasis and the increasing risk of developing diabetes, which makes a strong argument for a causal relationship between the two,” Dr Gelfand said.