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Risk of Infection in People with Diabetes
Diabetes Care; ePub 2018 Jan 12; Carey, et al
Persons with diabetes, particularly type 1 diabetes (T1DM), are at increased risk of serious infection compared with the general population, a recent study found. The retrospective cohort study compared 102,493 primary care patients aged 40-49 years with a diabetes diagnosis by 2008 (n=5,863 T1DM; n=96,630 T2DM) with 203,518 age-sex-practice-matched control participants without diabetes. Infection rates during 2008-2015 were compared across 19 individual infection categories. Researchers found:
- Patients with diabetes had higher rates for all infections compared with patients without diabetes, with the highest incidence rate ratios (IRRs) observed for bone and joint infections, sepsis, and cellulitis.
- IRRs for infection-related hospitalization were 3.71 for T1DM and 1.88 for T2DM.
- There were higher adjusted risks for T1DM vs T2DM (death from infection IRR 2.19).
- The authors estimated that 6% of infection-related hospitalizations and 12% of infection-related deaths were attributable to diabetes.
Carey IM, Critchley JA, DeWilde S, Harris T, Hosking FJ, Cook DG. Risk of infection in type 1 and type 2 diabetes compared with the general population: A matched cohort study. [Published online ahead of print January 12, 2018]. Diabetes Care. doi:10.2337/dc17-2131.
This study supports the clinical observation as well as previous studies that people with diabetes are more prone to infection than those without diabetes. What does this mean to us clinically? It can serve as a reminder about the importance of preventive efforts including pneumococcal vaccination for all patients with diabetes, annual flu vaccination, regular foot examination, and attentiveness to the possibility of serious infections when patients with diabetes present ill to the office. — Neil Skolnik, MD