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Eczema / Psoriasis News From Medical News Today
Link Between Severe Psoriasis And Increased Risk For Diabetes
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Also Included In: Diabetes
Article Date: 17 Oct 2012 – 0:00 PST Current ratings for:
Link Between Severe Psoriasis And Increased Risk For Diabetes 
An analysis of 27 studies linking psoriasis in 314,000 individuals with diabetes has found strong correlation between the scaly skin rash and the blood sugar disorder that predisposes patients to heart disease, say UC Davis researchers who led the review.
The findings appear in an article titled “Psoriasis and the risk of diabetes: a systematic review and meta-analysis,” which is now online in the Archives of Dermatology.
“Our investigation found a clear association between psoriasis and diabetes,” said April Armstrong, assistant professor of dermatology at UChttp://www.eczemablog.net/ Davis and principal investigator of the study. “Patients with psoriasis and their physicians need to be aware of the increased risk of developing diabetes so that patients can be screened regularly and benefit from early treatment.”
Psoriasis is a common skin problem that tends to run in families. It causes a raised red, flaky and sometimes itchy rash, often on the elbows and knees, although it can appear anywhere. It is believed to be an autoimmune disease, in which the body regards its own skin as foreign and mounts an inflammatory response.
Armstrong and her colleagues combined data from 27 observational studies of patients with psoriasis, in what is known as a meta-analysis. Five of the studies assessed the incidence of diabetes – that is, how many patients with psoriasis developed diabetes during the course of a study, which ranged from 10 to 22 years. The other studies assessed the prevalence of diabetes – how many patients already had diabetes at the outset of a study. Altogether, the studies evaluated more than 314,000 people with psoriasis and compared them to 3.7 million individuals (controls) without the disease.
Some of the studies classified patients by disease severity. The aggregate data for these studies showed that patients with mild psoriasis are over 1.5 times more likely to have diabetes than the general population while those with severe disease are nearly twice as likely. Among studies that assessed incidence, patients with psoriasis had a 27 percent increased risk of developing diabetes compared with the general population.
All but one study analyzing incidence found a link between psoriasis and diabetes. These studies included patient data from outpatient clinics, insurance claims and hospitals. Diabetes rates were similar in patients despite ethnicity or country where the study was conducted.
“The large sample size and consistent association between psoriasis and diabetes make these study findings very strong and suggest an underlying physiological link between the two diseases,” said Armstrong, who directs the Dermatology Clinical Research Unit at UC Davis and the teledermatology program.
While additional research is need to understand how the two diseases are associated, Armstrong believes altered immune pathways may make psoriasis patients more susceptible to developing diabetes.
“There is evidence that fat cells in psoriasis patients may not function normally,” she said. “These cells secrete inflammatory substances known as cytokines that increase insulin resistance in the liver and muscle and initiate destruction of insulin-producing cells in the pancreas.”
Additional research will also clarify other potential limiting factors in the current study. For example, the study’s authors noted that epidemiological or observational studies can be susceptible to confounding factors, such as concurrent medications used to treat psoriasis that may modulate the risk of developing diabetes.
Armstrong’s study adds to a growing body of research that shows psoriasis is not just skin deep. “We know patients with psoriasis and hypertension tend to require more aggressive therapy to bring their blood pressure under control,” said Armstrong. “We also know that psoriasis patients have higher rates of heart attacks, strokes and cardiovascular-related deaths than the general population. Primary-care physicians need to be aware of these underlying predispositions to disease to provide the best care to their patients.”
Armstrong and her colleagues plan to examine endothelial cells – cells that line blood vessels – to better understand the underlying physiological basis of psoriasis. They also are collaborating with other research institutions to develop a network to share clinical data on patients with psoriasis.
Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.Visit our eczema / psoriasis section for the latest news on this subject. The study’s other authors were Caitlin Harskamp, also of the UC Davis Department of Dermatology, and Ehrin Armstong, an interventional cardiologist with the UC Davis Division of Cardiovascular Medicine. Armstrong and her colleagues also received training and support for their systematic review and meta-analysis from the UC Davis Center for Healthcare Policy and Research.
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‘Link Between Severe Psoriasis And Increased Risk For Diabetes’
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Psoriasis Increases Risk Of Diabetes
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Article Date: 29 Aug 2012 – 1:00 PST Current ratings for:
Psoriasis Increases Risk Of Diabetes 
Patients with psoriasis are at high risk of new-onset diabetes mellitus, according to research presented at ESC Congress 2012. The findings were presented at the press conference by Dr Ole Ahlehoff from Copenhagen University Hospital, Gentofte, Denmark and at the scientific session by Usman KHALID.
Psoriasis is a common chronic inflammatory disease that affects approximately 125 million people worldwide. A new study of the entire Danish population confirms previous reports of increased risk of diabetes mellitus in patients with psoriasis and shows that risk increases with severity of psoriasis.
Psoriasis, atherosclerosis, and early steps in the development of diabetes mellitus are characterised by chronic inflammation, i.e. a chronic state of alert. “This chronic state of alert may explain the increased risk of cardiovascular diseases and diabetes mellitus seen in these patients,” said Dr Ahlehoff.
The study comprised more than 4 million people, including approximately 50,000 patients with psoriasis, who were followed for 13 years. http://www.eczemablog.net/
The overall rates of new-onset diabetes mellitus per 1,000 observational years were 3.67 (CI=3.65-3.69) in the reference population who did not have psoriasis, 6.93 (CI=6.63-7.25) for patients with mild psoriasis and 9.65 (CI=8.68-10.73) for patients with severe psoriasis.
The risk of new-onset diabetes mellitus was increased in all patients with psoriasis compared to people who did not have psoriasis. Risk increased with the severity of psoriasis. Compared to people without psoriasis, patients with mild psoriasis were 1.5 times more likely to acquire new-onset diabetes mellitus [rate ratio (RR)=1.49; CI=1.43-1.56] and patients with severe psoriasis were more than twice as likely [RR=2.13; CI=1.91-2.37].
The results remained significant after adjustment for potential confounders, including age, sex, socioeconomic status, use of medication, and comorbidity.
Dr Ahlehoff said: “The major conclusion of the study was that psoriasis was associated with increased risk of diabetes mellitus and the risk was highest in patients with severe psoriasis.”
“The results add to current evidence of increased risk of cardiovascular and metabolic disease in patients with psoriasis,” he added. “More needs to be done to increase awareness in this large group of patients on what steps they can take to decrease their risk factors for cardiovascular disease.”
Dr Ahlehoff continued: “Studies are urgently required to examine the impact of aggressive psoriasis treatment on cardiometabolic outcomes.”
Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.Visit our eczema / psoriasis section for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report:
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7 Apr. 2013.
Please note: If no author information is provided, the source is cited instead.
‘Psoriasis Increases Risk Of Diabetes’
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Psoriasis Patients Twice As Likely To Develop Diabetes
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Main Category: Eczema / Psoriasis
Also Included In: Diabetes;??Dermatology
Article Date: 16 Oct 2012 – 13:00 PST Current ratings for:
Psoriasis Patients Twice As Likely To Develop Diabetes 
http://www.eczemablog.net/
A new meta-analysis of 27 studies shows a clear link between people with psoriasis and diabetes.
The study, led by UC Davis researchers, was published online in Archives of Dermatology, and found a strong association between the dry skin rash and blood sugar disorder.
Psoriasis is widespread skin condition that runs in families. It is characterized by red, raised, flaky and often itchy, rash, and is found mostly on the knees and elbows, but can appear anywhere. Doctors believe it is an autoimmune disease; the body thinks of the skin as foreign and therefore gives off an inflammatory response. Earlier studies have hinted that psoriasis could be a risk factor for diabetes.
April Armstrong, assistant professor of dermatology at UC Davis and lead investigator of this study, and her team examined 27 studies of patients with psoriasis. Five of these studies looked at how many of the patients developed diabetes during the period of study, 10 to 22 years. The remainder of the studies assessed the incidence of diabetes at the commencement of the study. In total, they examined over 314,000 people with psoriasis and compared them with 3.7 million people without the disease (a control group).
The collection of data for these studies shows that patients with mild psoriasis are more than 1.5 times more likely to develop diabetes than the general public, while those suffering from severe psoriasis are twice as likely.
Studies that assessed prevalence found patients with psoriasis had a 27 percent elevated risk of getting diabetes, compared with the general public.
All but one study found a link between psoriasis and diabetes. These trials contained data from outpatient clinics, insurance claims, and hospitals. The rate of diabetes was the same regardless of patients’ ethnicities or countries. Armstrong explains:
“The large sample size and consistent association between psoriasis and diabetes make these study findings very strong and suggest an underlying physiological link between the two diseases.”
The authors admit that additional research is needed to interpret how the two diseases are intertwined. Armstrong suggests changed immune pathways may be responsible for making psoriasis patients more vulnerable to diabetes.
She goes on to say:
“There is evidence that fat cells in psoriasis patients may not function normally. These cells secrete inflammatory substances known as cytokines that increase insulin resistance in the liver and muscle and initiate destruction of insulin-producing cells in the pancreas.”
More research can also verify other possible limiting factors that are seen in the current study; a factor that could be confusing, like concurrent medications used to treat psoriasis that may change the risk of developing diabetes.
It has been known that blood pressure is harder to control in patients with psoriasis and also that psoriasis patients suffer higher instances of heart attack, strokes, and cardiovascular-related deaths. In order to provide the best and earliest care, it is imperative for physicians to be aware of these predispositions.
Armstrong and her team plan to study endothelial cells, cells that line the blood vessels, in order to interpret the unseen physiological basis of psoriasis. They will soon create a network to share clinical data on patients with psoriasis.
Written by Kelly Fitzgerald
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
April W. Armstrong, MD, MPH; Caitlin T. Harskamp, BA; Ehrin J. Armstrong, MD, MSc
Archives of Dermatology, October 2012, doi:10.1001/2013.jamadermatol.406 Please use one of the following formats to cite this article in your essay, paper or report:
MLA
7 Apr. 2013.
Please note: If no author information is provided, the source is cited instead.
‘Psoriasis Patients Twice As Likely To Develop Diabetes’
Please note that we publish your name, but we do not publish your email address. It is only used to let you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.
If you write about specific medications or operations, please do not name health care professionals by name.
All opinions are moderated before being included (to stop spam)
Contact Our News Editors
For any corrections of factual information, or to contact the editors please use our feedback form.
Please send any medical news or health news press releases to:
Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. For more information, please read our terms and conditions.
View the original article here
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