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Appendectomy and Subsequent Type 2 Diabetes - A National Cohort study
Jacob Antonsen1, Lars N Jørgensen2, Tine Jess3
1Digestive Disease Center, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
The Journal of Surgical Research
|July 3, 2026
Summary
Appendectomy slightly increases type 2 diabetes (T2D) risk, especially in older females. While linked to metabolic changes, the small effect size has limited clinical impact on surgical decisions for appendicitis.
Area of Science:
- Metabolic health
- Gastroenterology
- Epidemiology
Background:
- Appendectomy, the surgical removal of the appendix, can disrupt gut microbiota and alter metabolic homeostasis.
- Previous research on the association between appendectomy and type 2 diabetes (T2D) risk has yielded inconsistent findings.
- This study aimed to investigate the potential link between appendectomy and the incidence of T2D in a large, nationwide cohort.
Purpose of the Study:
- To evaluate the association between appendectomy and the subsequent development of type 2 diabetes (T2D).
- To assess if appendectomy influences T2D incidence in a nationwide cohort.
- To identify specific demographic groups, such as age and sex, that may be more susceptible to T2D after appendectomy.
Main Methods:
- A nationwide register-based cohort study included all Danish citizens from 1995 to 2022.
- Appendectomy cases were identified using national procedural codes, with each patient matched 1:10 by age and sex.
- Incident T2D was determined via diagnosis codes and prescription data, analyzed using Cox proportional hazards models.
Main Results:
- The study included 7,682,475 individuals, with 176,984 undergoing appendectomy.
- Over 24 million person-years of follow-up, appendectomy showed a slight association with increased T2D risk (adjusted HR 1.011).
- The increased risk was more pronounced in females and individuals over 40 years old.
Conclusions:
- Appendectomy is associated with a marginal increase in the risk of developing type 2 diabetes.
- This association is most notable in older individuals and females.
- The modest effect size suggests potential metabolic consequences but has limited clinical implications for surgical decision-making in appendicitis.
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