Abu-Ashour Waseem, Twells Laurie K, Valcour James E, Gamble John-Michael
School of Pharmacy, Health Sciences Centre, Memorial University of Newfoundland, St. John's, A1B 3V6, Newfoundland and Labrador, Canada.
Faculty of Medicine, Health Sciences Centre, Memorial University of Newfoundland, St. John's, A1B 3V6, Newfoundland and Labrador, Canada.
BMC Infect Dis. 2018 Feb 5;18(1):67. doi: 10.1186/s12879-018-2975-2.
People with diabetes may be at higher risk for acquiring infections through both glucose-dependent and biologic pathways independent of glycemic control. Our aim was to estimate the association between diabetes and infections occurring in primary care.
Using the Newfoundland and Labrador Sentinel of the Canadian Primary Care Sentinel Surveillance Network, patients with diabetes ≥18 years between 1 January 2008 and 31 March 2013 were included with at least 1-year of follow-up. We randomly matched each patient with diabetes on the date of study entry with up to 8 controls without diabetes. Primary outcome was the occurrence of ≥1 primary care physician visits for any infectious disease. Secondary outcomes included primary visits for head & neck, respiratory, gastrointestinal, genitourinary, skin and soft tissue, musculoskeletal, and viral infections. Using multivariable conditional logistic regression analysis, we measured the independent association between diabetes and the occurrence of infections.
We identified 1779 patients with diabetes who were matched to 11,066 patients without diabetes. Patients with diabetes were older, had a higher prevalence of comorbidities, and were more often referred to specialists. After adjusting for potential confounders, patients with diabetes had an increased risk of any infection compared to patients without diabetes (adjusted odds ratio = 1.21, 95% confidence interval 1.07-1.37). Skin and soft tissue infections had the strongest association, followed by genitourinary, gastrointestinal, and respiratory infections. Diabetes was not associated with head and neck, musculoskeletal, or viral infections.
Patients with diabetes appear to have an increased risk of certain infections compared to patients without diabetes.
糖尿病患者可能通过血糖依赖途径和与血糖控制无关的生物学途径而有更高的感染风险。我们的目的是评估糖尿病与基层医疗中发生的感染之间的关联。
利用加拿大基层医疗哨点监测网络的纽芬兰和拉布拉多哨点，纳入2008年1月1日至2013年3月31日期间年龄≥18岁且有至少1年随访期的糖尿病患者。我们在研究入组日期将每位糖尿病患者与多达8名非糖尿病对照进行随机匹配。主要结局是因任何传染病进行≥1次基层医疗医生就诊。次要结局包括因头颈部、呼吸道、胃肠道、泌尿生殖系统、皮肤和软组织、肌肉骨骼系统及病毒感染进行的基层就诊。使用多变量条件逻辑回归分析，我们测量了糖尿病与感染发生之间的独立关联。
我们确定了1779例糖尿病患者，他们与11066例非糖尿病患者进行了匹配。糖尿病患者年龄更大，合并症患病率更高，且更常被转诊至专科医生处。在调整潜在混杂因素后，与非糖尿病患者相比，糖尿病患者发生任何感染的风险增加（调整后的优势比=1.21，95%置信区间1.07-1.37）。皮肤和软组织感染的关联最强，其次是泌尿生殖系统、胃肠道和呼吸道感染。糖尿病与头颈部、肌肉骨骼系统或病毒感染无关。
与非糖尿病患者相比，糖尿病患者发生某些感染的风险似乎增加。
