Poor Glycemic Control Not tied to Increased Infection Risk in Diabetes patients, finds study
Researchers have discovered that long-term glycemic control does not affect the risk of bacterial infection in type 2 diabetes patients. A recent study was published in the journal PloS One by Edouard and colleagues. Diabetes mellitus affects a considerable part of the population worldwide, and its prevalence in France is estimated to be at 5.3% in 2020. Type 2 diabetes mellitus is the most common type and is linked to an increased risk of infection.
This study aimed to determine if glycemic control, determined by the levels of glycated hemoglobin, and severity of diabetes, as indicated by the number and type of antidiabetic drugs, are related to infectious risk. This was a cohort study based on data obtained from January 2012 to January 2022 from a French primary care database. Infectious risk was estimated using the mean number of antibiotic prescriptions per year, as an indicator of bacterial infections.
A retrospective cohort study looked at information from 59,020 patients, leading to analysis from 1,959 in the final instance. The glycemic control was classified on thresholds based on glycated hemoglobin and the severity of diabetes evaluated by the number and kind of antidiabetic treatments applied. The annual mean antibiotic prescriptions were taken as measurements of infectious risk. A sum of ANOVA tests was used in the statistics.
Main Results
• No relation between glycemic control and infection risk
• The mean count of antibiotic prescriptions per year was not significantly associated with glycated hemoglobin threshold level (p = 0.228).
Diabetes Severity and Infection Risk:
• Secondary analyses did not determine any association between the numbers of antidiabetic treatment and infection risk (p = 0.53). The type of antidiabetic treatment was also not significantly associated with antibiotic prescriptions (p = 0.018).
These findings can potentially change clinical strategies towards infection prevention among patients with type 2 diabetes, especially shifting the interest from glycaemic control to others such as immunity and comorbid conditions. In conclusion, long-term glycemic control and severity of diabetes were not correlated with the risk of bacterial infection in patients with type 2 diabetes. This research, for the first time, demonstrates how databases from primary care can contribute to advancing research and enhance our understanding of the complexities around managing diabetes and infectious risks.
Reference:
Lemoine, E., Dusenne, M., & Schuers, M. (2024). Glycemic control and bacterial infectious risk in type 2 diabetes: A retrospective cohort from a primary care database. PloS One, 19(12), e0314287. https://doi.org/10.1371/journal.pone.0314287
