The elevated infection risk among patients with type 2 diabetes (T2D) and prediabetes appears to be broadly similar across ethnic groups, according to study findings published in Diabetes Care.
Researchers in England evaluated data from primary care and linked hospitalization records between 2015 and 2019 to assess infections rates.
Of 527,151 patients with T2D and 273,216 with prediabetes, 70% were White, 10% were South Asian, 5% were Black, 5% were mixed/other, and 10% were not recorded.
Across ethnic groups, patients with T2D had increased risk for infections in primary care (incidence rate ratio [IRR], 1.51; 95% CI, 1.51-1.52) and hospitalizations (IRR, 1.91; 1.90-1.93). Patients with prediabetes had IRRs of 1.35 and 1.33, respectively.
In the T2D population, infections were highest among South Asian patients (235.1 per 1000 per year) and hospitalization infections were highest among White patients (68.0 per 1000 per year).
The relative increase in risk for infection outcomes was broadly similar across ethnic groups in patients without prediabetes or diabetes (incidence rate ratios [IRRs] for hospitalization were 1.98 for South Asian; 1.87 for Black; 1.98 for mixed/other; and 1.88 for White patients).
Adjustments were made for socioeconomic disparities, smoking status, and comorbid conditions, but IRRs continued to remain similar by ethnicity.
Age appeared to be a factor for relative risks. Patients with T2D younger than 50 years were 3 times more likely to be hospitalized with an infection than those without prediabetes or diabetes. However, absolute risk differences were found to be greater in older age.
“The burden of infections attributable to T2D and prediabetes is signiﬁcant and will continue to have public health implications with their rising prevalence. Efforts to reduce infection risk in people with diabetes remains an important challenge in all ethnic groups,” the study authors noted.
They concluded that better glucose monitoring and diabetes control among the highest-risk individuals may improve infection outcomes, though there remains a knowledge gap among healthcare professionals.
Carey IM, Critchley JA, Chaudhry UAR, et al. Evaluating ethnic variations in the risk of infections in people with prediabetes and type 2 diabetes: a matched cohort study. Diabetes Care. Published online April 12, 2023. doi:10.2337/dc22-2394