Glycemic Control and Risk of Infections Among People With Type 1 or Type 2 Diabetes in a Large Primary Care Cohort Study

Background: Diabetes mellitus increases the risk of infections and results in adverse outcomes, but the effect of better glycaemic control has not been thoroughly investigated. Therefore, it was intended to study the various types of infections in Type 2 diabetic patients and its correlation with HbA1c.Methods: It was a prospective observational study for one year, conducted on Type 2 diabetic patients hospitalized for various causes. Patients with HIV infection or immunocompromised state were excluded. Routine investigations, radiological and culture studies were conducted as required to identify the various infections present. The prevalence of infections was then corelated with blood glucose and HbA1c levels.Results: Total 105 hospitalized diabetic cases were studied, out of which infections were detected in 72 (68.6%) patients, which was found to be statistically significant. The most common infection detected was UTI (45.8%). Among the UTI patients, E. coli was the most common organism isolated (52.3%) followed by Enterococcus (19%), Pseudomonas (19%) and Citrobacter (9.5%). Infections occurred in 61 (82.4%) patients with HbA1C >6.5% and in 11 (35.5%) patients with HbA1C <6.5%, which was found to be statistically significant.Conclusions: Diabetes increases the risk of infections. Urinary tract infection is the most common infection, affecting the females predominantly. An association between current hyperglycaemia, glycosylated haemoglobin and infection risk in type 2 diabetes patients was found.

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“…13 Julia et al, also concluded that poor glycemic control is powerfully associated with serious infections in diabetic patients. 14…”

Section: Discussionmentioning

confidence: 99%

Infections in type 2 diabetic patients and its correlations with glycosylated haemoglobin in a tertiary care teaching hospital

Mohapatra¹,

Soreng

Mohanty

et al. 2019

Int J Res Med Sci

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“…Diabetes mellitus is a well-established risk factor for infections, and the risk increases with poor glycemic control 6 . In general, glycated hemoglobin (HbA1c) >9% has been shown to be associated with 60% increased risk of severe bacterial pneumonia 7 .…”

Section: Diabetes Mellitus and Obesity Are Risk Factors For Severity mentioning

confidence: 99%

Dissecting the interaction between COVID‐19 and diabetes mellitus

Chee

Tan

Yeoh

2020

J of Diabetes Invest

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Coronavirus disease 2019 (COVID‐19) is a global pandemic that is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus‐2. Data from several countries have shown higher morbidity and mortality among individuals with chronic metabolic diseases, such as diabetes mellitus. In this review, we explore the contributing factors for poorer prognosis in these individuals. As a significant proportion of patients with COVID‐19 also have diabetes mellitus, this adds another layer of complexity to their management. We explore potential interactions between antidiabetic medications and renin–angiotensin–aldosterone system inhibitors with COVID‐19. Suggested recommendations for the use of antidiabetic medications for COVID‐19 patients with diabetes mellitus are provided. We also review pertinent clinical considerations in the management of diabetic ketoacidosis in COVID‐19 patients. In addition, we aim to increase clinicians’ awareness of the metabolic effects of promising drug therapies for COVID‐19. Finally, we highlight the importance of timely vaccinations for patients with diabetes mellitus.

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“…Analysis of patients with type 1 and type 2 diabetes enrolled in primary care in England have shown a clear increase in long-term risk of infection with increasing HbA1c [ 32 ]. In a population-based study from Denmark, individuals with HbA1c of 10.5% and above had hazards ratio of 1.64 for infections requiring hospitalization, compared to individuals with HbA1c between 5.50 and 6.49% [ 33 ].…”

Section: Effect Of Hyperglycemia and Glycemic Control On Infectionsmentioning

confidence: 99%

Infections and diabetes: Risks and mitigation with reference to India

Unnikrishnan

Misra

2020

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background and aims The link between diabetes and increased risk of infectious disease has long been recognized, but has re-entered sharp focus following the COVID-19 pandemic. Methods A literature search was conducted in PubMed for articles in English on diabetes and infection. Results Diabetes predisposes to infections through alterations in innate and acquired immune defenses. Outcomes of infection are worse in people with uncontrolled diabetes, and infection can worsen hyperglycemia in hitherto well controlled diabetes (bidirectional relationship). Diabetes does not increase the risk of infection with COVID-19 per se, but predisposes to severe disease and poor outcomes. COVID-19 has also been linked to deterioration of glycemic control as well as new-onset diabetes. Conclusions Clinicians caring for people with diabetes should be aware of the increased risk of infections in this population, as well as the possibility of worsening hyperglycemia. A holistic approach with frequent monitoring of blood glucose levels and appropriate titration of medications, along with close attention to nutritional status, is essential to ensure the best possible outcomes.

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Glycemic Control and Risk of Infections Among People With Type 1 or Type 2 Diabetes in a Large Primary Care Cohort Study

Abstract: Poor glycemic control is powerfully associated with serious infections and should be a high priority.

Cited by 306 publications

References 30 publications

Infections in type 2 diabetic patients and its correlations with glycosylated haemoglobin in a tertiary care teaching hospital

Infections in type 2 diabetic patients and its correlations with glycosylated haemoglobin in a tertiary care teaching hospital

Dissecting the interaction between COVID‐19 and diabetes mellitus

Infections and diabetes: Risks and mitigation with reference to India

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