Glycemic control and bacterial infectious risk in type 2 diabetes: A retrospective cohort from a primary care database

PLoS One. 2024 Dec 13;19(12):e0314287. doi: 10.1371/journal.pone.0314287. eCollection 2024.

Abstract

Objective: 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.

Materials and methods: 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.

Results: 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.

Conclusion: Long-term glycemic control was not associated with bacterial infectious risk in patients with type 2 diabetes.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy
  • Bacterial Infections / epidemiology
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Databases, Factual*
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • France / epidemiology
  • Glycated Hemoglobin* / analysis
  • Glycated Hemoglobin* / metabolism
  • Glycemic Control*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Primary Health Care*
  • Retrospective Studies
  • Risk Factors

Substances

  • Glycated Hemoglobin
  • Hypoglycemic Agents
  • Anti-Bacterial Agents
  • Blood Glucose

Grants and funding

The author(s) received no specific funding for this work.