People with diabetes may be at higher risk for acquiring infections through both glucose-dependent and biologic pathways independent of glycemic control. Abu-Ashour, et al. (2018) sought to estimate the association between diabetes and infections occurring in primary care.
Using the Newfoundland and Labrador Sentinel of the Canadian Primary Care Sentinel Surveillance Network, patients with diabetes ≥18 years between Jan. 1, 2008 and March 31, 2013 were included with at least one year of follow-up. The researchers randomly matched each patient with diabetes on the date of study entry with up to 8 controls without diabetes. Primary outcome was the occurrence of ≥1 primary care physician visits for any infectious disease. Secondary outcomes included primary visits for head and neck, respiratory, gastrointestinal, genitourinary, skin and soft tissue, musculoskeletal, and viral infections. Using multivariable conditional logistic regression analysis, they measured the independent association between diabetes and the occurrence of infections.
The researchers identified 1779 patients with diabetes who were matched to 11,066 patients without diabetes. Patients with diabetes were older, had a higher prevalence of comorbidities, and were more often referred to specialists. After adjusting for potential confounders, patients with diabetes had an increased risk of any infection compared to patients without diabetes (adjusted odds ratio = 1.21, 95% confidence interval 1.07–1.37). Skin and soft tissue infections had the strongest association, followed by genitourinary, gastrointestinal, and respiratory infections. Diabetes was not associated with head and neck, musculoskeletal, or viral infections.
The researchers concluded that patients with diabetes appear to have an increased risk of certain infections compared to patients without diabetes.
Reference: Abu-Ashour W, Twells LK, Valcour JE and Gamble J-M. Diabetes and the occurrence of infection in primary care: a matched cohort study. BMC Infectious Diseases. 2018;18:67