Eli Lilly and Company Indianapolis, Indiana, United States
Background: Rhabdomyolysis is rare, serious, and potentially life-threatening. The condition has diverse causes, including hypoxic (e.g., carbon monoxide poisoning), physical (e.g., trauma), chemical (e.g., medications), and biologic (e.g., venoms and diabetic ketoacidosis) risk factors. There is limited information on the epidemiology of rhabdomyolysis in general population, including those with diabetes.
Objectives: To characterize the epidemiology of rhabdomyolysis in patients with type 2 diabetes (T2D).
Methods: Administrative claims from Truven Health MarketScan database were used to estimate the incidence and prevalence rates of rhabdomyolysis in patients with T2D between 2015 and 2016. Rates were compared to those without diabetes, and stratified by age, gender, and co-existence of chronic kidney disease (CKD). Patients with new rhabdomyolysis events during 2016 were included in incidence, and those with any record of rhabdomyolysis during 2015 and 2016, which could include those with past medical history or an acute event of rhabdomyolysis were included in prevalence. The 9th and 10th versions of the International Classification of Disease diagnosis codes were used to define the conditions.
Results: During the analysis period 711,490 patients with T2D (corresponding to 149,455 with CKD and 562,035 without CKD) and 27,499,728 without diabetes were identified. Compared to individuals without diabetes, those with diabetes had higher rates of rhabdomyolysis (prevalence, 0.2% vs. 0.1%; incidence, 0.13 vs. 0.04 per 100 person-years). Among patients with T2D, those with CKD had about twice the rates of those without CKD (prevalence, 2.8% vs. 1.3%; incidence, 0.52 vs. 0.25 per 100 person-years). Rates increased by age, especially among ≥70 years old and males. The majority of patients with T2D were treated with lipid-lowering therapy; however, treatment did not appear to alter the observed rates.
Conclusions: Patients with T2D, especially those with CKD, are at risk for rhabdomyolysis and should be considered as potential comorbidity during T2D management.