アブストラクト | AIMS: People with type 1 diabetes (T1D) have raised infection rates compared to those without, but how these risks vary by age, sex and ethnicity, or by glycated haemoglobin (HbA1c), remain uncertain. METHODS: 33,829 patients with T1D in Clinical Practice Research Datalink on 01/01/2015 were age-sex-ethnicity matched to two non-diabetes patients. Infections were collated from primary care and linked hospitalisation records during 2015-2019, and incidence rate ratios (IRRs) were estimated versus non-diabetes. For 26,096 people with T1D, with >/=3 HbA1c measurements in 2012-2014, mean and coefficient of variation were estimated, and compared across percentiles. RESULTS: People with T1D had increased risk for infections presenting in primary care (IRR = 1.81, 95%CI 1.77-1.85) and hospitalisations (IRR = 3.37, 3.21-3.53) compared to non-diabetes, slightly attenuated after further adjustment. Younger ages and non-White ethnicities had greater relative risks, potentially explained by higher HbA1c mean and variability amongst people with T1D within these sub-groups. Both mean HbA1c and greater variability were strongly associated with infection risks, but the greatest associations were at the highest mean levels (hospitalisations IRR = 4.09, 3.64-4.59) for >97 versus </=53 mmol/mol. CONCLUSIONS: Infections are a significant health burden in T1D. Improved glycaemic control may reduce infection risks, while prompter infection treatments may reduce hospital admissions. |
ジャーナル名 | Diabetes research and clinical practice |
Pubmed追加日 | 2023/11/21 |
投稿者 | Chaudhry, Umar A R; Carey, Iain M; Critchley, Julia A; DeWilde, Stephen; Limb, Elizabeth S; Bowen, Liza; Panahloo, Arshia; Cook, Derek G; Whincup, Peter H; Harris, Tess |
組織名 | Population Health Research Institute, St George's, University of London, London;SW17 0RE, United Kingdom. Electronic address: uchaudhr@sgul.ac.uk.;SW17 0RE, United Kingdom.;St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting,;London SW17 0QT, United Kingdom. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37984487/ |