Headache and type 2 diabetes association: a US national ambulatory case-control study.

Objective: We investigate the joint observation between type 2 diabetes and headache using a cross-sectional case-control study of a US ambulatory dataset. Background: Recent whole-population cohort studies propose that type 2 diabetes may have a protective effect against headache prevalence. With headaches ranked as a leading cause of disability, headache-associated comorbidities could help identify shared molecular mechanisms. Methods: We performed a cross-sectional case-control study using the US National Ambulatory Medical Care Survey, 2009, on the joint observation between headache and specific comorbidities, namely type 2 diabetes, hypertension and anxiety, for all patients between 18 and 65 years of age. The odds ratio of having a headache and a comorbidity were calculated using conditional logistic regression, controlling for gender and age over a study population of 3,327,947 electronic health records in the absence of prescription medication data. Results: We observed estimated odds ratio of 0.89 (95% CI: 0.83-0.95) of having a headache and a record of type 2 diabetes over the population, and 0.83 (95% CI: 2.02-2.57) and 0.89 (95% CI: 3.00-3.49) for male and female, respectively. Conclusions: We find that patients with type 2 diabetes are less likely to present a recorded headache indication. Patients with hypertension are almost twice as likely of having a headache indication and patients with an anxiety disorder are almost three times as likely. Given the possibility of confounding indications and prescribed medications, additional studies are recommended.