Evidence map›Paper›PMID 42288642›Full record

ArticleScientific reports2026

Combined impact of diabetes mellitus and substance use on injury risk: a nationwide population-based cohort study in Taiwan.

Chun-Liang Wu, Yao-Ching Huang, Ren-Jei Chung, Shi-Hao Huang, Tsu-Hsuan Weng, Bing-Long Wang, Chun-Teng Tsai, Chi-Hsiang Chung, Pi-Ching Yu, Chao-Hsi Huang and 1 more

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Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Chun-Liang WuGraduate Institute of Medical Sciences College of Medicine, National Defense Medical University, 11490, Taipei, Taiwan.
Yao-Ching HuangDepartment of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), 10608, Taipei, Taiwan.
Ren-Jei ChungDepartment of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), 10608, Taipei, Taiwan.
Shi-Hao HuangDepartment of Chemical Engineering and Biotechnology, National Taipei University of Technology (Taipei Tech), 10608, Taipei, Taiwan.
Tsu-Hsuan WengDepartment of Medical Research Tri-Service General Hospital, National Defense Medical University, 11490, Taipei, Taiwan.
Bing-Long WangGraduate Institute of Public Health College of Public Health, National Defense Medical University, 11490, Taipei, Taiwan.
Chun-Teng TsaiDepartment of Medical Research Tri-Service General Hospital, National Defense Medical University, 11490, Taipei, Taiwan.
Chi-Hsiang ChungDepartment of Medical Research Tri-Service General Hospital, National Defense Medical University, 11490, Taipei, Taiwan.
Pi-Ching YuGraduate Institute of Medical Sciences College of Medicine, National Defense Medical University, 11490, Taipei, Taiwan.
Chao-Hsi HuangDepartment of Computer Science and Information Engineering, National Ilan University, Yilan County, 26047, Taiwan.
Wu-Chien ChienGraduate Institute of Medical Sciences College of Medicine, National Defense Medical University, 11490, Taipei, Taiwan. chienwu@mail.ndmctsgh.edu.tw.

Funding

Tri-Service General Hospital TSGH-A-115015, TSGH-B-115018, TSGH-A-114010, TSGH-B-114022, TSGH-D-114196
6 · The paper itself

Abstract

This study aimed to examine the independent and combined impacts of diabetes mellitus (DM), and substance use on the risk of accidental injuries in a nationwide population-based cohort in Taiwan. Using Taiwan's National Health Insurance Research Database (NHIRD), two retrospective cohorts were analyzed. The DM cohort (2000-2013) included 31,424 patients with DM and 94,272 age-, sex-, and index-year-matched controls. The substance uses cohort (2013-2022) included 324,648 substance users and an equal number of matched controls. Injury outcomes were classified as traffic accidents, falls, burns and fires, brain injuries, suicide, and drowning. Cox proportional hazards models were applied to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs), and Kaplan-Meier analyses were used for descriptive visualization of cumulative injury risk, and interaction was formally assessed using Cox regression models. Patients with DM exhibited a 1.702-fold higher risk of injury compared to non-DM individuals, while substance users demonstrated a 1.444-fold higher risk compared to non-users. Among substance users, the highest risks were found for suicide (aHR = 10.287), intentional injury (aHR = 2.453), and falls (aHR = 1.742). Female sex, low income, major illness, and comorbidities (stroke, hypertension, hyperlipidemia) further amplified injury risk. Both DM and substance use were independently associated with increased injury risk. In joint-effects analyses, individuals with both DM and substance use had the highest injury risk among the four exposure groups (non-DM/non-user, DM only, substance use only, and DM + substance use). The multiplicative interaction between DM and substance use was statistically significant. Results were consistent in sensitivity analyses restricted to unintentional injuries. DM and substance use independently elevate the risk of accidental and intentional injuries; their coexistence is associated with the highest injury risk that markedly increases injury susceptibility. Integrating chronic disease management with substance use prevention and behavioral interventions may reduce injury-related morbidity and mortality in high-risk populations.

Indexed as

Diabetes MellitusSubstance-Related DisordersWounds and InjuriesAccidental FallsAdultAgedCohort StudiesFemaleHumansMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesRisk FactorsTaiwanCox regressionDiabetes mellitus (DM)Injury riskKaplan–meier analysisNationwide cohortSubstance useTaiwan

Identifiers

PMID42288642
PMCPMC13521928

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.