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Clinical Summary

Diabetes raises the risk for serious infections and associated outcomes

Takeaway

  • Patients with diabetes are at increased risk for serious infections and also have a higher risk for infection-related death and hospitalisation.

Why this matters

  • Risk of infection in diabetes has been clinically established and causally linked to impaired immune responses, neuropathy, and altered lipid metabolism.
  • UK guidelines for type 2 diabetes mellitus (T2DM) do not mention infection as a possible complication or offer any specific guidelines for its management and prevention.

Study design

  • Retrospective cohort study of 102,493 patients (type 1 diabetes mellitus [T1DM], n=5863; T2DM, n=96,630) and 203,518 matched control patients.
  • Funding: None disclosed.

Key results

  • In patients with T1DM, incident rate ratio (IRR) was significantly high for bone and joint infections (22.34), endocarditis (6.70) and sepsis (6.10).
  • In patients with T2DM, IRR was high for bone and joint infections (4.93), sepsis (2.25) and cellulitis (2.03).
  • IRR for infection-related hospitalisations was 3.71 (95% CI, 3.27-4.21) for T1DM and 1.88 (95% CI, 1.83-1.92) for T2DM.
  • Risk for death resulting from infection was significantly higher in patients with T1DM (IRR, 7.72) vs patients with T2DM (IRR, 1.92).
  • Risk for sepsis was significantly higher in patients with diabetes (IRR, 2.03) vs control patients.

Limitations

  • Patients younger than 40 years were not included.

References


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