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Diabetes mellitus and invasive pneumococcal disease in Spain: a retrospective study

Enrique Gea-Izquierdo1,2,3, Rossana Ruiz-Urbaez4, Valentín Hernández-Barrera5

  • 1Faculty of Medicine, Pontifical Catholic University of Ecuador, Quito, Ecuador. enriquegea@yahoo.es.

BMC Infectious Diseases
|September 27, 2025
PubMed
Abstract

Insights

Diabetes mellitus (DM) increases the risk of invasive pneumococcal disease (IPD). Patients with type 1 DM face a higher IPD hospitalization risk, especially with comorbidities, impacting the Spanish health system.

Area of Science:

  • Infectious Diseases
  • Endocrinology
  • Public Health

Background:

  • Diabetes mellitus (DM) is a prevalent global disease and a known risk factor for invasive pneumococcal disease (IPD).
  • IPD is a serious infection caused by Streptococcus pneumoniae (SP).
  • This study investigates IPD in Spanish patients with DM, considering comorbidities and other infections like influenza, COVID-19, and RSV.

Purpose of the Study:

  • To analyze the incidence and risk factors of invasive pneumococcal disease (IPD) in hospitalized patients with diabetes mellitus (DM) in Spain.
  • To assess the association between DM, comorbidities, and IPD hospitalization.
  • To evaluate the impact of influenza, COVID-19, and RSV on IPD risk in DM patients.

Main Methods:

  • Retrospective analysis of hospital discharge reports from the Spanish Minimum Basic Data Set (1997-2022).
  • Inclusion of patients with type 1 and type 2 diabetes mellitus.
  • Statistical analysis using Student's t-test, chi-square test, and logistic regression to determine risk factors and odds ratios for IPD.

Main Results:

  • Over 12.9 million patients with DM were identified; 3.43% had type 1 DM and 96.57% had type 2 DM.
  • The incidence of Streptococcus pneumoniae infection was 0.50% in type 1 DM and 0.66% in type 2 DM.
  • Patients with type 1 DM showed a significantly higher risk of IPD hospitalization, particularly with comorbidities, while the risk associated with Influenza, COVID-19, and RSV was low.

Conclusions:

  • Diabetes mellitus and comorbidities are significant factors contributing to invasive pneumococcal disease (IPD).
  • The findings highlight the substantial impact of IPD on patients with DM within the Spanish healthcare system.
  • Further research and preventive strategies are warranted to mitigate IPD risk in diabetic populations.
Keywords:
COVID-19Diabetes mellitusHospitalizationInfluenzaInvasive pneumococcal diseaseRSV diseaseSpain

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