Mortality from infectious diseases in diabetes

Area of Science:

• Epidemiology
• Public Health
• Diabetology

Background:

• Diabetes mellitus is a chronic condition affecting millions globally.
• Infections pose a significant threat to individuals with diabetes, potentially leading to severe complications and mortality.
• Understanding the precise impact of infections on mortality in diabetic populations is crucial for public health strategies.

Purpose of the Study:

• To investigate the mortality risk associated with infections in individuals with diabetes.
• To compare the accuracy of using underlying causes of death versus multiple causes of death in assessing infection-related mortality.
• To quantify the excess mortality from infections in a large cohort of diabetic subjects.

Main Methods:

• A cohort of 185,341 diabetic subjects (aged 30-89) in Italy was identified in 2010.
• Causes of death were analyzed from 2010 to 2015, comparing underlying versus multiple causes.
• Standardized Mortality Ratios (SMRs) were calculated against regional mortality rates.

Main Results:

• An increased risk of death from infection-related causes was observed in diabetic subjects (SMR=1.83).
• Specific infections showed elevated mortality risks: septicemia (SMR=1.91) and pneumonia (SMR=1.47).
• The multiple causes of death approach highlighted a stronger association between infectious diseases and mortality than underlying causes alone.

Conclusions:

• Diabetic patients experience excess mortality due to infection-related diseases.
• Routine mortality analyses using only underlying causes may underestimate the true impact of infections on mortality in diabetes.
• Comprehensive death certificate analysis is essential for accurately assessing infection-related mortality in diabetic populations.