Hemorrhoid risk among people with diabetes mellitus using glucose lowering agents.

We investigated whether there is an association between using antidiabetic agents (ADAs) or insulin and hemorrhoid risk among people with diabetes mellitus (DM). We have essentially used a massive dataset to identify a statistical association between ADAs and hemorrhoidal disease. The hazard ratios (HRs) and 95% confidence intervals (CIs) for hemorrhoids were estimated using univariate and multivariate Cox proportional hazards models. Covariates used in the multivariate models included age, sex, comorbidities, and medications. A total of 126,897 patients who had DM between 2009 and 2016 were involved in this study. The joint effect analysis showed that anyone receiving medication therapy with dipeptidyl peptidase IV (DPP IV) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose cotransporter-2 inhibitors (SGLT2i) can significantly lower the risk of hemorrhoid with the adjusted HR (aHR) of 0.64, 95% CI=0.62-0.67; aHR of 0.29, 95% CI=0.24-0.35; and aHR of 0.14, 95% CI=0.11-0.18, respectively. We found that SGLT2i is more potent for hemorrhoid prophylaxis in incidence rate among DM patients.