Lemoine Edouard, Dusenne Mikaël, Schuers Matthieu
Department of General Practice, UNIROUEN, Normandie Université, Rouen, France.
Department of Medical Information and Informatics, CHU Rouen, Rouen, France.
PLoS One. 2024 Dec 13;19(12):e0314287. doi: 10.1371/journal.pone.0314287. eCollection 2024.
The prevalence of diabetes was estimated at 5.3% of the French population in 2020. People with type 2 diabetes have an increased risk of infection. Currently, there is no consensus on the impact of glycemic control on infectious risk. The objective was to evaluate whether glycemic control and diabetes severity were associated with infectious risk in type 2 diabetes.
We designed a multicenter retrospective cohort study using data from a French primary care database. Data were collected from January 2012 to January 2022. Glycemic control was estimated by the threshold of glycated hemoglobin and diabetes severity by the number, and the type, of antidiabetic treatments. Infectious risk was evaluated by the mean of antibiotic prescriptions per year.
Among 59,020 patients, 1959 patients were included in the final analysis. The threshold of glycated hemoglobin was not associated with the mean of antibiotic prescriptions per year (ANOVA p = 0.228). Secondary analyses did not show an association between the number, or the type, of antidiabetic treatments and the mean of antibiotic prescriptions per year (p = 0.53 and p = 0.018, respectively). No association was observed between glycemic control, diabetes severity and infectious risk in patients with type 2 diabetes. This is the first European study using data from primary care to examine bacterial infectious risk in patients with type 2 diabetes, demonstrating the possibilities offered by the use of databases in primary care research.
Long-term glycemic control was not associated with bacterial infectious risk in patients with type 2 diabetes.
据估计，2020年法国糖尿病患病率为5.3%。2型糖尿病患者感染风险增加。目前，关于血糖控制对感染风险的影响尚无共识。目的是评估血糖控制和糖尿病严重程度是否与2型糖尿病患者的感染风险相关。
我们利用法国初级保健数据库的数据设计了一项多中心回顾性队列研究。数据收集时间为2012年1月至2022年1月。通过糖化血红蛋白阈值评估血糖控制情况，通过抗糖尿病治疗的数量和类型评估糖尿病严重程度。通过每年抗生素处方的平均值评估感染风险。
在59020名患者中，1959名患者纳入最终分析。糖化血红蛋白阈值与每年抗生素处方的平均值无关（方差分析p = 0.228）。二次分析未显示抗糖尿病治疗的数量或类型与每年抗生素处方的平均值之间存在关联（分别为p = 0.53和p = 0.018）。在2型糖尿病患者中，未观察到血糖控制、糖尿病严重程度与感染风险之间存在关联。这是第一项利用初级保健数据研究2型糖尿病患者细菌感染风险的欧洲研究，证明了在初级保健研究中使用数据库的可能性。
2型糖尿病患者的长期血糖控制与细菌感染风险无关。
