OBJECTIVEWe retrospectively assessed the age- and sex-specific incidence and relative risk of Parkinson disease (PD) in Taiwan’s diabetic population.RESEARCH DESIGN AND METHODSStudy cohort included 603,416 diabetic patients and 472,188 nondiabetic control subjects. Incidence rate and relative risk of PD (ICD-9-CM 332.0) were evaluated.RESULTSThe incidence of PD was 3.59 and 2.15 per 10,000 person-years for the diabetic and control group, respectively, representing a covariate adjusted hazard ratio (HR) of 1.61 (95% CI 1.56–1.66), which was substantially reduced to 1.37 (1.32–1.41) after adjusting for medical visits. Diabetes was associated with a significantly elevated risk of PD in all sex and age stratifications except in young women, with the highest HR noted for young men aged 21–40 years (2.10 [1.01–4.42]), followed by women aged 41–60 (2.05 [1.82–2.30]) and >60 years (1.65 [1.58–1.73]).CONCLUSIONSDiabetes is associated with an increased risk of PD onset in a Chinese population, and the relation is stronger in women and younger patients.

We prospectively investigated 615,532 diabetic patients and 614,871 age-matched and sexmatched control subjects selected from National Health Insurance claims for malignant neoplasms of liver and biliary tract (International Statistical Classification of Diseases and Related Health Problems, 9th edition, codes 155 and 156, respectively) between 2000 and 2006. The person-year approach with Poisson assumption was used to estimate the hazard rates. We also evaluated the age-specific and sex-specific relative risks of these two malignancies in relation to diabetes with Cox proportional hazard regression model with adjustment for potential confounders. The overall hazard rate of malignant neoplasm of the liver was 32.76 and 17.41 per 10,000 patient-years, respectively, for diabetic men and women; the corresponding figures for biliary tract neoplasm were much lower at 1.42 and 1.60 per 10,000 patient-years. Compared with control subjects, diabetic patients had a two-fold increased risk of malignant neoplasm of the liver, but this risk was attenuated by adjusting for selected clinical risk factors (hazard ratio [HR] 1.21; 95% confidence interval [CI] 1.17-1.25). Additionally, diabetic patients were associated with increased risk of biliary neoplasms with an approximate magnitude of 20%-30%, but the HR was attenuated and became insignificant after adjustment for clinical risk factors (HR 1.07; 95% CI 0.95-1.21). Diabetic patients with cirrhosis had the highest relative risk of liver neoplasm (HR 85.25;), whereas those with cholangitis had the highest risk of biliary tract neoplasm (HR 70.30;) compared with control subjects without any clinical risk factors. Conclusion: This population-based study confirms the association of diabetes with liver neoplasm and suggests that diabetic patients with certain clinical risk factors should be educated for strict adherence of liver neoplasm screening. (HEPATOLOGY 2010;52:155-163)

OBJECTIVE -Using the National Health Insurance claim data, we prospectively investigated the age-and sex-specific incidence density and relative hazards of nontraumatic lowerextremity amputation (LEA) and peripheral revascularization procedure (PRP) of the diabetic population in Taiwan.RESEARCH DESIGN AND METHODS -A total of 500,868 diabetic patients and 500,248 age-and sex-matched control subjects, selected from the ambulatory care claim (1997) and the registry for beneficiaries, respectively, were linked to inpatient claims (1997)(1998)(1999)(2000)(2001)(2002) to identify hospitalizations due to nontraumatic LEA and PRP. Incidence density was calculated under the Poisson assumption, and the Kaplan-Meier analysis was used to assess the cumulative event rates over a 6-year follow-up period. We also evaluated the age-and sex-specific relative hazards of nontraumatic LEA and PRP in relation to diabetes with Cox proportional hazard regression model adjusted for demographics and regional areas.RESULTS -The estimated incidence density of nontraumatic LEA and PRP for diabetic men was 410.3 and 317.0 per 100,000 patient-years, respectively. The corresponding data for diabetic women were relatively low at 115.2 and 86.0 per 100,000 patient-years. Compared with control subjects with the same age and sex, diabetic patients consistently suffered from significantly elevated relative hazards of nontraumatic LEA. Young and female patients were especially vulnerable to experience increased risks of nontraumatic LEA, but such effect modification by age and sex was less apparent for PRP.CONCLUSIONS -Multidisciplinary diabetes foot care systems, including the provision of revascularization procedures, should be further enforced to reduce subsequent risks of nontraumatic LEA, especially in young and female diabetic patients. Diabetes Care

The rate of seropositive anti-HCV is 2.8 times higher in type 2 DM patients than non-diabetic control subjects.