Herpes zoster (HZ), or shingles, is a common neurocutaneous disease caused by reactivation of latent varicella-zoster-virus that often includes vesicular rash and neuropathic pain, the latter which may last for months or years. Several studies suggest that type-2 diabetes mellitus (T2DM) may represent an important risk factor for the development of HZ. This retrospective claims database analysis assessed the incidence of HZ in patients with T2DM in the US and measured the impact of HZ on T2DM treatment.
Marketscan family of databases from 2013-2018 (Commercial, Medicare) or 2013-2017 (Medicaid) for adults aged 18 years and older was utilized. Crude rate incidence and incidence rate ratio (IRR) adjusted for age, gender, and payer type were calculated. Diabetes Complications Severity Index (DCSI), Charlson Comorbidity Index (CCI) scores and observed treatment usage (e.g. number of prescriptions, number of covered days) were determined before and after an HZ episode. The overall crude rate incidence of HZ in patients with T2DM was 1.01% or 0.010 per person per year; in comparison, the overall crude rate incidence of HZ among patients without T2DM was 0.5%. The adjusted IRR was 1.68 (95% confidence interval: 1.67-1.70). Patients with T2DM and HZ had a mean age of 62 years, and 86% were commercially insured. An episode of HZ did not change either the DCSI or the CCI score. Regardless of HZ status, the most common T2DM complications were hypertension (78.9% in patients with T2DM only, 81.2% with T2DM and HZ), chronic pulmonary disease (20.1% and 24.3% respectively) and depression (14.1% and 16.3% respectively). Finally, an episode of HZ did not impact T2DM treatment usage.
In conclusion, patients with T2DM had 1.68 times the risk of having an HZ episode compared to patients without T2DM. An episode of HZ among patients with T2DM does not appear to specifically impact T2DM complications/severity or its treatment.
