Prevalence and Impact of Diabetes Mellitus in Gout: Analysis of a Nationwide Dataset of 192,062 Hospitalizations

<b>Objectives</b>: The variable clustering of comorbidities in gout, including diabetes mellitus (DM), remains poorly understood. We analyzed the frequency and impact of DM in a nationwide Spanish hospitalized population with gout. <b>Methods</b>: Observational, multicenter, longitudinal study assessing 192,062 hospitalizations with gout in Spain from 2005 to 2015 (Minimal Basic Data Set, ICD-9 coding)<b>.</b> We estimated the prevalence of DM with 95% confidence intervals (CIs), stratified by DM type and related complications. A logistic regression analysis identified characteristics of patients with both gout and DM. We also matched recurrent admissions in the first tercile (2005-2008) to assess cardiovascular, renal, infectious, and thromboembolic comorbidities in the subsequent terciles (2009-2012 and 2012-2015). <b>Results</b>: DM was identified in 27.72% of the hospital-based gout population, predominantly type 2 DM, with 19.76% having complications. DM was associated with older age, female gender, and conditions such as dyslipidemia, obesity, cardiovascular and kidney diseases, liver disease, obstructive pulmonary disease, urinary tract infections, and dementia. In contrast, non-DM patients showed higher rates of venous thromboembolism and other rheumatic diseases. Readmissions were significantly more common in DM patients, who experienced +10% more cardiovascular and renal issues, similar infections, and fewer venous thromboembolism cases. <b>Conclusions</b>: DM is prevalent in gout and associated with older patients, women, and a particular comorbidity profile. The presence of DM increases the risks of readmission and the development of cardiovascular and renal diseases. Fewer venous thromboses were noted. Thus, diagnosing and managing DM in patients with gout is likely a more pressing issue.