Diabetes And Prediabetes Linked To Susceptibility Of Severe Infection, Study Finds

Diabetes is known to be a risk factor for several health conditions such as heart disease, kidney problems, and nerve damage, among others. However, a new study says there's another major health issue that might be getting far less attention than it deserves; infections. Researchers say that infections should be considered a serious health hazard for people living with diabetes and even for those with prediabetes. The findings of the study come from one of the largest studies ever conducted on the subject.

Researchers examined health records from more than 800,000 people in England with type 1 diabetes, type 2 diabetes, or prediabetes and compared them with more than one million people without diabetes. The results showed that the risk of infection was consistently high across the entire diabetes spectrum.

What The Study Examined

The study was carried out by researchers at City St George's, University of London and was published in the journal Diabetes. It was also presented at the American Diabetes Association Scientific Sessions in New Orleans. Researchers used anonymised general practitioner (GP) records linked with hospital admission and mortality data to track infection outcomes over a five-year period.

The analysis included 33,829 people with type 1 diabetes, 527,151 people with type 2 diabetes, and 273,216 people with prediabetes. Their health outcomes were compared with those of more than one million individuals without diabetes who were matched for age, sex, and ethnicity.

Higher Infection Risk Across All Groups

Researchers found that people with diabetes faced a significantly greater risk of infections treated in primary care, infections requiring hospital admission, and infection-related deaths. The highest risks were seen among people with type 1 diabetes.

People with type 1 diabetes had an 81% higher chance of developing infections that were diagnosed and treated by their GP. Their risk of being hospitalised because of an infection was 337% higher than that of people without diabetes.

For people with type 2 diabetes, the risk was also significantly high. They had a 51% higher chance of primary care infections and a 91% greater risk of infection-related hospitalisation. Even people with prediabetes, who are often considered to be at an early stage before diabetes develops, were not spared. They faced a 35% higher risk of infections managed in primary care and a 33% increased risk of hospitalisation due to infections.

Infection Emerges As A Major Cause Of Death

One of the study's most important findings was the role of infection in mortality among people with type 2 diabetes. Researchers found that infection was the third most common underlying cause of death in this group, ranking behind cardiovascular disease and cancer.

The findings suggest that infections are not just occasional complications but represent a significant health burden. Despite this, infection prevention and management are usually not emphasised in diabetes care.

Professor Julia Critchley, Professor of Epidemiology from the School of Health & Medical Sciences at City St George's, University of London, who led the study said, "Infections are a major health hazard across the diabetes spectrum and are hiding in plain sight. They are common, serious, and often preventable, yet they are mostly absent from clinical guidelines.

"The number of people living with diabetes across the world is on a dangerously steep rise, and it's a disservice if we do not treat infection risk as a core part of diabetes care. It cannot be an afterthought."

Which Infections Were Most Common?

The study identified lower respiratory tract infections, including pneumonia, as the most common infections leading to hospitalisation among people with type 1 and type 2 diabetes. Researchers also found that sepsis and lower respiratory tract infections were the leading causes of infection-related deaths in people with type 2 diabetes.

These findings are important because respiratory infections can become severe quickly, especially in people whose immune systems may already be compromised by long-term metabolic conditions. Early diagnosis and treatment could therefore play a key role in reducing serious outcomes.

Blood Sugar Control Matters

The study also explored how blood sugar levels influence infection risk. In people with type 1 diabetes, higher blood sugar levels were directly linked to an increased likelihood of infection. However, for people with type 2 diabetes, fluctuations in blood sugar levels over time appeared to be particularly important.

This means that even individuals whose average blood sugar readings seem acceptable may still face a higher risk if their glucose levels vary significantly.

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