Healthy Lifestyle May Cut Infection Risk by 44% in Type 2 Diabetes: Study
Adherence to a healthy lifestyle may reduce the incidence of infections by approximately 44% among patients with type 2 diabetes mellitus (T2DM). The findings highlight the importance of lifestyle measures as a potential strategy to lower infection risk in this vulnerable population, which is already at increased susceptibility to infectious diseases. The study was published in the journal BMC Medicine by Mingming Li and colleagues.
To determine the link between health-related factors of various dimensions and infectious events, investigators conducted a prospective cohort study on 12,885 patients with T2DM from the UK Biobank (mean age: 60.1 years; 30.6% women [3,943/12,885]) for a median follow-up of 13.1 years. The key exposures consisted of adherence to a healthy lifestyle (based on smoking status, body mass index [BMI], dietary intake, exercise, sleep time, and alcohol consumption) and LE8 score of individual subjects based on 9,164 individuals.
The main outcome was infection events (in addition to other secondary outcomes such as pneumonia, gastroenteritis, and sepsis) ascertained from hospital discharge and mortality registry data. In order to understand the biological pathways of this link, investigators carried out multi-omics mediation analyses using nuclear magnetic resonance metabolomics in 8,971 subjects (325 metabolic biomarkers) and Olink proteomics in 1,078 subjects (2,920 proteins).
Key findings:
- Ideal lifestyle adherence was associated with a 44% lower overall infection incidence rate compared to poor adherence (incidence rate ratio [IRR], 0.56; 95% CI, 0.46–0.68), with parallel reductions observed for pneumonia and sepsis.
- The four protective lifestyle factors against infection that were most strongly established included never having smoked, having a healthy BMI, getting enough sleep, and exercising regularly.
- LE8 scores demonstrated a clear dose-dependent protective association, where each 5-point increase in the total LE8 score was linked to an 11% lower infection incidence rate (IRR, 0.89; 95% CI, 0.87–0.91).
- Mediation models were able to confirm that lipid and fatty acid measures such as the degree of fatty acid unsaturation, HDL-associated lipid sub-fractions, and levels of GlycA accounted for the protective associations.
- Plasma protein profiling helped in the identification of key inflammatory and innate immune signaling proteins, including TRAIL-R2 and Galectin-9, as significant biological mediators between the lifestyle score and risk of infection.
In summary, living a healthy life and attaining better LE8 levels will minimize infection cases among people suffering from type 2 diabetes. The findings show that the above health measures are associated with good immunity through changes in the lipid metabolism and immune-inflammation processes. This research proves that optimizing the lifestyle is a crucial intervention in diabetes management to prevent severe infections among patients.
Reference:
Li, M., Zhai, H., Dai, X. et al. Healthy lifestyle is associated with lower infection incidence in type 2 diabetes: A prospective cohort study with multi-omics mediation analysis. BMC Med (2026). https://doi.org/10.1186/s12916-026-05162-7
