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Risk of Infection in Type 1 and Type 2 Diabetes Compared With the General Population: A Matched Cohort Study
Iain M Carey1, Julia A Critchley2, Stephen DeWilde2
1Population Health Research Institute, St George's, University of London, London, U.K. i.carey@sgul.ac.uk.
Diabetes Care
|January 14, 2018
Summary
Adults with diabetes, especially type 1, face a higher risk of serious infections. This study highlights the significant burden of infections in diabetic populations and calls for new prevention strategies.
Area of Science:
- Epidemiology
- Diabetology
- Infectious Diseases
Background:
- Diabetes mellitus is a global health concern associated with numerous complications.
- Infections represent a significant cause of morbidity and mortality in individuals with diabetes.
- Understanding infection burden differences between type 1 and type 2 diabetes is crucial for targeted interventions.
Purpose of the Study:
- To quantify the burden of infections in adults with diabetes.
- To compare infection rates between patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM).
- To assess the attributable risk of diabetes to infection-related hospitalizations and deaths.
Main Methods:
- Retrospective cohort study of 102,493 English primary care patients with diabetes (5,863 T1DM, 96,630 T2DM) and 203,518 matched controls.
- Infection rates (prescriptions, hospitalizations, mortality) analyzed from 2008-2015 using linked primary care, hospital, and mortality records.
- Poisson regression used to calculate incidence rate ratios (IRRs) comparing diabetes vs. controls and T1DM vs. T2DM, adjusted for covariates.
Main Results:
- Patients with diabetes exhibited higher rates of all infections compared to controls, with elevated IRRs for bone/joint infections, sepsis, and cellulitis.
- Infection-related hospitalizations were significantly higher in T1DM (IRR 3.71) than T2DM (IRR 1.88).
- T1DM patients had a higher risk of death from infection (IRR 2.19) compared to T2DM patients. Diabetes accounted for 6% of infection hospitalizations and 12% of infection deaths.
Conclusions:
- Individuals with diabetes, particularly T1DM, face an elevated risk of severe infections, posing a substantial public health challenge.
- The findings underscore the need for enhanced strategies to mitigate infection risk and improve outcomes in diabetic populations.
- Further research into preventative measures and treatment optimization for infections in diabetes is warranted.
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