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November 19, 2013; 81 (21) Article

Spinal cord injury and type 2 diabetes

Results from a population health survey

Jacquelyn J. Cragg, Vanessa K. Noonan, Marcel Dvorak, Andrei Krassioukov, G.B. John Mancini, Jaimie F. Borisoff
First published October 23, 2013, DOI: https://doi.org/10.1212/01.wnl.0000436074.98534.6e
Jacquelyn J. Cragg
From the School of Population and Public Health, Faculty of Medicine (J.J.C.), International Collaboration on Repair Discoveries (J.J.C., A.K., J.F.B.), Division of Spine, Department of Orthopaedics (M.D.), Department of Medicine, Division of Physical Medicine and Rehabilitation (A.K.), and Cardiovascular Imaging Research Core Laboratory, Division of Cardiology, Department of Medicine (G.B.J.M.), University of British Columbia, Vancouver; Rick Hansen Institute (V.K.N.), Vancouver; Acute Spine Program (M.D.), Vancouver General Hospital; GF Strong Rehabilitation Centre (A.K.), Vancouver Health Authority, Vancouver; and British Columbia Institute of Technology (J.F.B.), Burnaby, Canada.
MPH
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Vanessa K. Noonan
From the School of Population and Public Health, Faculty of Medicine (J.J.C.), International Collaboration on Repair Discoveries (J.J.C., A.K., J.F.B.), Division of Spine, Department of Orthopaedics (M.D.), Department of Medicine, Division of Physical Medicine and Rehabilitation (A.K.), and Cardiovascular Imaging Research Core Laboratory, Division of Cardiology, Department of Medicine (G.B.J.M.), University of British Columbia, Vancouver; Rick Hansen Institute (V.K.N.), Vancouver; Acute Spine Program (M.D.), Vancouver General Hospital; GF Strong Rehabilitation Centre (A.K.), Vancouver Health Authority, Vancouver; and British Columbia Institute of Technology (J.F.B.), Burnaby, Canada.
PhD
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Marcel Dvorak
From the School of Population and Public Health, Faculty of Medicine (J.J.C.), International Collaboration on Repair Discoveries (J.J.C., A.K., J.F.B.), Division of Spine, Department of Orthopaedics (M.D.), Department of Medicine, Division of Physical Medicine and Rehabilitation (A.K.), and Cardiovascular Imaging Research Core Laboratory, Division of Cardiology, Department of Medicine (G.B.J.M.), University of British Columbia, Vancouver; Rick Hansen Institute (V.K.N.), Vancouver; Acute Spine Program (M.D.), Vancouver General Hospital; GF Strong Rehabilitation Centre (A.K.), Vancouver Health Authority, Vancouver; and British Columbia Institute of Technology (J.F.B.), Burnaby, Canada.
MD, FRCSC
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Andrei Krassioukov
From the School of Population and Public Health, Faculty of Medicine (J.J.C.), International Collaboration on Repair Discoveries (J.J.C., A.K., J.F.B.), Division of Spine, Department of Orthopaedics (M.D.), Department of Medicine, Division of Physical Medicine and Rehabilitation (A.K.), and Cardiovascular Imaging Research Core Laboratory, Division of Cardiology, Department of Medicine (G.B.J.M.), University of British Columbia, Vancouver; Rick Hansen Institute (V.K.N.), Vancouver; Acute Spine Program (M.D.), Vancouver General Hospital; GF Strong Rehabilitation Centre (A.K.), Vancouver Health Authority, Vancouver; and British Columbia Institute of Technology (J.F.B.), Burnaby, Canada.
MD, PhD, FRCPC
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G.B. John Mancini
From the School of Population and Public Health, Faculty of Medicine (J.J.C.), International Collaboration on Repair Discoveries (J.J.C., A.K., J.F.B.), Division of Spine, Department of Orthopaedics (M.D.), Department of Medicine, Division of Physical Medicine and Rehabilitation (A.K.), and Cardiovascular Imaging Research Core Laboratory, Division of Cardiology, Department of Medicine (G.B.J.M.), University of British Columbia, Vancouver; Rick Hansen Institute (V.K.N.), Vancouver; Acute Spine Program (M.D.), Vancouver General Hospital; GF Strong Rehabilitation Centre (A.K.), Vancouver Health Authority, Vancouver; and British Columbia Institute of Technology (J.F.B.), Burnaby, Canada.
MD, FRCPC, FACC
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Jaimie F. Borisoff
From the School of Population and Public Health, Faculty of Medicine (J.J.C.), International Collaboration on Repair Discoveries (J.J.C., A.K., J.F.B.), Division of Spine, Department of Orthopaedics (M.D.), Department of Medicine, Division of Physical Medicine and Rehabilitation (A.K.), and Cardiovascular Imaging Research Core Laboratory, Division of Cardiology, Department of Medicine (G.B.J.M.), University of British Columbia, Vancouver; Rick Hansen Institute (V.K.N.), Vancouver; Acute Spine Program (M.D.), Vancouver General Hospital; GF Strong Rehabilitation Centre (A.K.), Vancouver Health Authority, Vancouver; and British Columbia Institute of Technology (J.F.B.), Burnaby, Canada.
PhD
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Citation
Spinal cord injury and type 2 diabetes
Results from a population health survey
Jacquelyn J. Cragg, Vanessa K. Noonan, Marcel Dvorak, Andrei Krassioukov, G.B. John Mancini, Jaimie F. Borisoff
Neurology Nov 2013, 81 (21) 1864-1868; DOI: 10.1212/01.wnl.0000436074.98534.6e

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Abstract

Objective: The objective of this study was to evaluate the association between spinal cord injury (SCI) and type 2 diabetes in a large representative sample and to determine whether an association exists irrespective of known risk factors for type 2 diabetes.

Methods: Data were obtained on 60,678 respondents to the Statistics Canada 2010 Cycle of the cross-sectional Canadian Community Health Survey. Multivariable logistic regression, incorporating adjustment for confounders and probability weights to account for the Canadian Community Health Survey sampling method, was conducted to quantify this association.

Results: After adjustment for both sex and age, SCI was associated with a significant increased odds of type 2 diabetes (adjusted odds ratio = 1.66, 95% confidence interval 1.16–2.36). These heightened odds persisted after additional adjustment for smoking status, hypertension status, body mass index, daily physical activity, alcohol intake, and daily consumption of fruits and vegetables (fully adjusted odds ratio = 2.45, 95% confidence interval 1.34–4.47).

Conclusions: There is a strong association between SCI and type 2 diabetes, which is not explained by known risk factors for type 2 diabetes.

GLOSSARY

AOR=
adjusted odds ratio;
CCHS=
Canadian Community Health Survey;
CI=
confidence interval;
OR=
odds ratio;
SCI=
spinal cord injury

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received May 14, 2013.
  • Accepted in final form August 21, 2013.
  • © 2013 American Academy of Neurology
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