Excess risk of dying from infectious causes in those with type 1 and type 2 diabetes

Magliano, Dianna Josephine, Harding, Jessica L., Cohen, Kerryn, Huxley, Rachel R., Davis, Wendy A. and Shaw, Jonathan E. (2015) Excess risk of dying from infectious causes in those with type 1 and type 2 diabetes. Diabetes Care, 38 7: 1274-1280. doi:10.2337/dc14-2820


Author Magliano, Dianna Josephine
Harding, Jessica L.
Cohen, Kerryn
Huxley, Rachel R.
Davis, Wendy A.
Shaw, Jonathan E.
Title Excess risk of dying from infectious causes in those with type 1 and type 2 diabetes
Journal name Diabetes Care   Check publisher's open access policy
ISSN 0149-5992
1935-5548
Publication date 2015-07-01
Sub-type Article (original research)
DOI 10.2337/dc14-2820
Open Access Status Not Open Access
Volume 38
Issue 7
Start page 1274
End page 1280
Total pages 7
Place of publication Alexandria, VA, United States
Publisher American Diabetes Association
Language eng
Formatted abstract
Objective: To investigate infection-related mortality in individuals with type 1 and type 2 diabetes.

Research design and methods: A total of 1,108,982 individuals with diabetes who were registered with the Australian Diabetes register between 2000 and 2010 were linked to the National Death Index. Mortality outcomes were defined as infection-relatedA-B death (ICD codes A99–B99), pneumonia (J12–J189), septicemia (A40 and A41), and osteomyelitis (M86).

Results: During a median follow-up of 6.7 years, there were 2,891, 2,158, 1,248, and 147 deaths from infection-relatedA-B causes, pneumonia, septicemia, or osteomyelitis, respectively. Crude mortality rates from infectionsA-B were 0.147 and 0.431 per 1,000 person-years in type 1 and type 2 diabetes, respectively. Standardized mortality ratios (SMRs) were higher in type 1 and type 2 diabetes for all outcomes after adjustment for age and sex. For infection-relatedA-B mortality, SMRs were 4.42 (95% CI 3.68–5.34) and 1.47 (1.42–1.53) for type 1 and type 2 diabetes (P < 0.001), respectively. For pneumonia in type 1 diabetes, SMRs were approximately 5 and 6 in males and females, respectively, while the excess risk was ∼20% for type 2 (both sexes). For septicemia, SMRs were approximately 10 and 2 for type 1 and type 2 diabetes, respectively, and similar by sex. For osteomyelitis in type 1 diabetes, SMRs were 16 and 58 in males and females, respectively, and ∼3 for type 2 diabetes (both sexes).

Conclusions: Although death owing to infection is rare, we confirm that patients with diabetes have an increased mortality from a range of infections, compared with the general population, and that the increased risk appears to be greater for type 1 than type 2 diabetes.
Keyword Community acquired pneumonia
Population based cohort
Glycemic control
Mortality trends
Mellitus
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Public Health Publications
 
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