Impact of Glycemic Control on Risk of Infections in Patients with Type 2 Diabetes: A populationbased cohort study

Anil Mor, Olaf M Dekkers, Jens S Nielsen, Henning Beck-Nielsen, Henrik T. Sørensen, Reimar W. Thomsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying HbA1c values and development of community antiinfective-treated and hospital-treated infections in 69,318 patients with type 2 diabetes diagnosed between 2000 and 2012 in Northern Denmark. Incidence rates were 394/1,000 patient-years for community-treated infections and 63/1,000 patient-years for hospital-treated infections. The adjusted hazard ratios for community-treated infection at an HbA1c level of ≥10.5%, as compared with 5.5% to <6.5%, were 0.97 (95% confidence interval (CI): 0.94, 1.00) for HbA1c measured at early baseline, 1.09 (95% CI: 1.03, 1.14) for updated mean HbA1c, 1.13 (95% CI: 1.08, 1.19) for updated time-weighted mean HbA1c, and 1.19 (95% CI: 1.14, 1.26) for the latest updated HbA1c (reference HbA1c 5.5% to <6.5%). Corresponding estimates for hospital-treated infections were 1.08 (95% CI: 1.02, 1.14) for early baseline HbA1c, 1.55 (95% CI: 1.42, 1.71) for updated mean HbA1c, 1.58 (95% CI: 1.44, 1.72) for updated time-weighted mean HbA1c, and 1.64 (95% CI: 1.51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association of current hyperglycemia with infection risk in type 2 diabetes patients.

OriginalsprogEngelsk
TidsskriftAmerican Journal of Epidemiology
Vol/bind186
Udgave nummer2
Sider (fra-til)227-236
ISSN0002-9262
DOI
StatusUdgivet - 2017

Fingeraftryk

Type 2 Diabetes Mellitus
Cohort Studies
Confidence Intervals
Denmark
Hyperglycemia
Regression Analysis
Incidence

Citer dette

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title = "Impact of Glycemic Control on Risk of Infections in Patients with Type 2 Diabetes: A populationbased cohort study",
abstract = "Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying HbA1c values and development of community antiinfective-treated and hospital-treated infections in 69,318 patients with type 2 diabetes diagnosed between 2000 and 2012 in Northern Denmark. Incidence rates were 394/1,000 patient-years for community-treated infections and 63/1,000 patient-years for hospital-treated infections. The adjusted hazard ratios for community-treated infection at an HbA1c level of ≥10.5{\%}, as compared with 5.5{\%} to <6.5{\%}, were 0.97 (95{\%} confidence interval (CI): 0.94, 1.00) for HbA1c measured at early baseline, 1.09 (95{\%} CI: 1.03, 1.14) for updated mean HbA1c, 1.13 (95{\%} CI: 1.08, 1.19) for updated time-weighted mean HbA1c, and 1.19 (95{\%} CI: 1.14, 1.26) for the latest updated HbA1c (reference HbA1c 5.5{\%} to <6.5{\%}). Corresponding estimates for hospital-treated infections were 1.08 (95{\%} CI: 1.02, 1.14) for early baseline HbA1c, 1.55 (95{\%} CI: 1.42, 1.71) for updated mean HbA1c, 1.58 (95{\%} CI: 1.44, 1.72) for updated time-weighted mean HbA1c, and 1.64 (95{\%} CI: 1.51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association of current hyperglycemia with infection risk in type 2 diabetes patients.",
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note = "{\circledC} The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
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Impact of Glycemic Control on Risk of Infections in Patients with Type 2 Diabetes : A populationbased cohort study. / Mor, Anil; Dekkers, Olaf M; Nielsen, Jens S; Beck-Nielsen, Henning; Sørensen, Henrik T.; Thomsen, Reimar W.

I: American Journal of Epidemiology, Bind 186, Nr. 2, 2017, s. 227-236.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Impact of Glycemic Control on Risk of Infections in Patients with Type 2 Diabetes

T2 - A populationbased cohort study

AU - Mor, Anil

AU - Dekkers, Olaf M

AU - Nielsen, Jens S

AU - Beck-Nielsen, Henning

AU - Sørensen, Henrik T.

AU - Thomsen, Reimar W.

N1 - © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2017

Y1 - 2017

N2 - Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying HbA1c values and development of community antiinfective-treated and hospital-treated infections in 69,318 patients with type 2 diabetes diagnosed between 2000 and 2012 in Northern Denmark. Incidence rates were 394/1,000 patient-years for community-treated infections and 63/1,000 patient-years for hospital-treated infections. The adjusted hazard ratios for community-treated infection at an HbA1c level of ≥10.5%, as compared with 5.5% to <6.5%, were 0.97 (95% confidence interval (CI): 0.94, 1.00) for HbA1c measured at early baseline, 1.09 (95% CI: 1.03, 1.14) for updated mean HbA1c, 1.13 (95% CI: 1.08, 1.19) for updated time-weighted mean HbA1c, and 1.19 (95% CI: 1.14, 1.26) for the latest updated HbA1c (reference HbA1c 5.5% to <6.5%). Corresponding estimates for hospital-treated infections were 1.08 (95% CI: 1.02, 1.14) for early baseline HbA1c, 1.55 (95% CI: 1.42, 1.71) for updated mean HbA1c, 1.58 (95% CI: 1.44, 1.72) for updated time-weighted mean HbA1c, and 1.64 (95% CI: 1.51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association of current hyperglycemia with infection risk in type 2 diabetes patients.

AB - Infections are a major clinical challenge for type 2 diabetes patients, but little is known about the impact of glycemic control. We used Cox regression analyses to examine the association between baseline and time-varying HbA1c values and development of community antiinfective-treated and hospital-treated infections in 69,318 patients with type 2 diabetes diagnosed between 2000 and 2012 in Northern Denmark. Incidence rates were 394/1,000 patient-years for community-treated infections and 63/1,000 patient-years for hospital-treated infections. The adjusted hazard ratios for community-treated infection at an HbA1c level of ≥10.5%, as compared with 5.5% to <6.5%, were 0.97 (95% confidence interval (CI): 0.94, 1.00) for HbA1c measured at early baseline, 1.09 (95% CI: 1.03, 1.14) for updated mean HbA1c, 1.13 (95% CI: 1.08, 1.19) for updated time-weighted mean HbA1c, and 1.19 (95% CI: 1.14, 1.26) for the latest updated HbA1c (reference HbA1c 5.5% to <6.5%). Corresponding estimates for hospital-treated infections were 1.08 (95% CI: 1.02, 1.14) for early baseline HbA1c, 1.55 (95% CI: 1.42, 1.71) for updated mean HbA1c, 1.58 (95% CI: 1.44, 1.72) for updated time-weighted mean HbA1c, and 1.64 (95% CI: 1.51, 1.79) for the latest updated HbA1c. Our findings provide evidence for an association of current hyperglycemia with infection risk in type 2 diabetes patients.

KW - Journal Article

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DO - 10.1093/aje/kwx049

M3 - Journal article

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JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

SN - 0002-9262

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