Type 2 diabetes results in increased infection rates, particularly amongst people with poor glycaemic control: population-based cohort study
PHE ePoster Library. de Lusignan S. 09/13/16; 137942; 132
Prof. Simon de Lusignan
Prof. Simon de Lusignan
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Abstract Introduction: Micro and macro-vascular complications constitute the main public health burden from diabetes. Diabetes is also associated with increased infection rates, however high-quality data is lacking about the relationship between infection rates and glycaemic control.Methods: Infection rates during 2014 were compared between people with and without type 2 diabetes (T2DM) in a large primary care cohort: Royal College of General Practitioners Research and Surveillance Centre. For people with T2DM, the independent impact of glycaemic control on infection rates was determined using multi-level logistic regression modelling controlling for key demographic factors and co-morbidities. The most recent glycated haemoglobin (HbA1c) was used as a marker of glycaemic control. We studied influenza-like illness, herpes simplex, upper and lower respiratory tract, urinary tract, skin and soft tissue, intestinal, and genital and perineal infections.Results: Rates were higher amongst people with T2DM (n=34,278) than those without (n=615,559) for all infections studied, except herpes simplex. Total adjusted infection rates were 502 (95%CI 467-634) versus 268 (95%CI 267-270) infections per 1,000 for people with and without T2DM respectively. A 1% rise in T2DM diabetes prevalence would result in 128,000 (95%CI 108,000- 201,000) additional infectious episodes per year in England. In T2DM, adjusted rates of bronchitis, pneumonia, urinary tract, skin and soft tissue, and genital and perineal infections showed a significant positive correlation with worsening glycaemic control.Conclusion: People with T2DM are more prone to infection, particularly those with poor glycaemic control. Preventing the increasing T2DM burden is paramount to prevent a consequent increase in infectious diseases.
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