In a nutshell
This study investigated the link between glycemic control (control of blood glucose levels) and the risk of infections in people with diabetes. It was determined that poor glycemic control is associated with a higher risk of infection, especially in people with type 1 diabetes (T1D).
Some background
T1D and type 2 diabetes (T2D) can increase the risk of infection. The effect of glycemic control on this risk is still under investigation.
Glycemic control can be monitored by HbA1c levels (measures average blood glucose in the last 3 months).
Methods & findings
This study used an English healthcare database to gather information on 85,312 adults with diabetes (both T1D and T2D). They were compared to 153,341 similar adults without diabetes (control group). The average HbA1c level during the years 2008 and 2009 was calculated for every patient in the diabetes group. Both groups were then followed up for 5 years for the development of infection.
Patients in the diabetes group with HbA1c levels between 6-7% (good glycemic control) were 41% more likely than the control group to be hospitalized for infections. Patients with diabetes with HbA1c levels above 11% (poor glycemic control) were 4.7 times more likely to be hospitalized for infections than the control group. Patients with T1D and poor glycemic control were 8.47 times more likely to be hospitalized for infections than the control group. Those with T2D were 4.31 times more likely than the control group to be hospitalized for infections.
Patients in the diabetes group with good glycemic control were 63% more likely than the control group to die due to infection. The risk was 5.51 times higher in those with poor glycemic control than the control group.
The most common infections associated with HbA1c levels outside the 6-7% range were bone and joint infections (46%), infection in the heart (endocarditis; 26.2%) and tuberculosis (23.7%).
The bottom line
The study concluded that higher HbA1c levels are associated with a greater risk of infection in people with diabetes. This is especially true in people with T1D.
The fine print
Information about the participants was gathered from a database. The researchers did not interview or examine the patients. This means they could not check that all of the data was accurate.
What’s next?
Discuss your risk of developing infections with your physician and how can you improve your glycemic control.
Published By :
Diabetes Care
Date :
Aug 13, 2018
