Diabetes is associated with increased risk of venous thromboembolism: A systematic review and meta-analysis

• The association between diabetes and VTE risk is controversial.
• We performed an updated meta-analysis to further investigate the issue.
• A much larger sample size and more subgroup analyses were achieved.
• Diabetes is associated with increased risk of VTE.

AimsIncreasing evidence suggests an association between diabetes and risk of venous thromboembolism (VTE); however, the results are inconsistent. We conducted a systematic review and meta-analysis of all epidemiological evidence to clarify association of diabetes with risk of VTE.MethodsWe searched MEDLINE and EMBASE to retrieve all relevant articles. Pooled effect estimates were calculated through a random-effects model.ResultsSixteen articles involving 803,627,121 participants and 10,429,227 VTE patients were included. Pooled analysis of all evidence suggested that diabetes was associated with increased risk of VTE (HR, 1.35; 95%CI, 1.17-1.55; p = 2.92*10- 5), with evidence of small-study effect (p = 0.024) and heterogeneity (I2 = 87.1%, p < 0.001). However, when analysis was restricted to high quality cohort studies, the association remained significantly (HR, 1.36; 95%CI 1.11-1.68; p = 0.004), with no evidence of publication bias (p = 0.192) and heterogeneity (I2 = 23.2%, p = 0.245).ConclusionsDiabetes is associated with increased risk of VTE, which may have implications for the primary and secondary prevention of VTE.