Major burns increase the risk for the development of diabetes mellitus in later life: A TriNetX study

While the early metabolic hallmarks of major burns are well established, less clear are the potential long-term metabolic consequences, including any future risk of dysregulated glucose metabolism. To address this, a real-world database of ~125 million patients (TriNetX), was examined. Adult patients treated for large burns (≥30% total body surface area) or routine immunization (control comparator), with no prior diagnosis of diabetes mellitus, were identified. The two groups were propensity score matched, resulting in a final pool of 5,139 patients per group, balanced for age (40.6 ±18.3 years), sex (69.7% male), race and ethnicity (all P = 1.00). Using Kaplan-Meier survival analysis, the incidence of diabetes diagnosis in the 15-year period following the index event (burn or routine immunization) was determined. The estimated 15-year cumulative incidence of a diabetes diagnosis was 16.5% and 12.2% in the burn and comparator groups, respectively (log rank test: P=0.0003), indicating that burn injury is significantly associated with an increased risk of diabetes within the 15-year post-burn period. Notably, both groups displayed equivalent degrees of adiposity, with the burn and comparator groups having an average BMI of 28.5 ±6.6 and 28.4 ±6.8 kg.m -2 , respectively (P=0.77). In summary, our data suggests that following major burns, patients remain at a heightened risk for the development of diabetes several years post injury. • A major burn (≥30% TBSA) is associated with increased long-term diabetes risk. • Elevated diabetes risk observed throughout the 15-year post-burn follow-up. • Analysis based on a real-world cohort of over 10,000 propensity-matched patients. • Addresses a gap in knowledge on long-term metabolic outcomes after burns.