Association between Psoriasis and Type 2 Diabetes in Adults: A Propensity Score–Matched Cohort Study

The association between psoriasis and type 2 diabetes mellitus is documented, yet validation using large-scale, real-world data remains essential. This study aimed to examine this association in patients aged 20–84 years. A retrospective cohort study was conducted using the 2006–2025 TriNetX Network database. Patients aged 20–84 were categorized into two groups: those diagnosed with psoriasis and those without (control group). Propensity score matching was applied to balance baseline characteristics. The primary outcome was the incidence of type 2 diabetes mellitus. Cumulative incidence, hazard ratio, and 95% confidence interval were calculated using the TriNetX “Compare Outcomes Analysis”. After matching, each group included 19,924 patients. Over the observation period (maximum up to 20 years), the cumulative incidence of type 2 diabetes was 2.206% in the psoriasis group and 0.166% in the control group. The estimated hazard ratio was 7.225 (95% confidence interval: 5.072–10.292). The magnitude of this association should be interpreted with caution due to residual confounding, differences in follow-up duration, and potential surveillance bias. Beyond its cutaneous manifestations, psoriasis was associated with an increased risk of type 2 diabetes mellitus in this large real-world cohort, underscoring the importance of integrated metabolic risk management in psoriasis care. These findings should be interpreted cautiously given the observational design and the potential for residual confounding and surveillance bias.