Display options
Cite
Simonsen JR, Harjutsalo V, Järvinen A, et al. Bacterial infections in patients with type 1 diabetes: a 14-year follow-up study. BMJ Open Diabetes Res Care. 2015;3(1):e000067doi: 10.1136/bmjdrc-2014-000067.
Simonsen, J. R., Harjutsalo, V., Järvinen, A., Kirveskari, J., Forsblom, C., Groop, P. H., Lehto, M. (2015). Bacterial infections in patients with type 1 diabetes: a 14-year follow-up study. BMJ open diabetes research & care, 3(1), e000067. https://doi.org/10.1136/bmjdrc-2014-000067
Simonsen, Johan R, et al. "Bacterial infections in patients with type 1 diabetes: a 14-year follow-up study." BMJ open diabetes research & care vol. 3,1 (2015): e000067. doi: https://doi.org/10.1136/bmjdrc-2014-000067
Simonsen JR, Harjutsalo V, Järvinen A, Kirveskari J, Forsblom C, Groop PH, Lehto M. Bacterial infections in patients with type 1 diabetes: a 14-year follow-up study. BMJ Open Diabetes Res Care. 2015 Mar 05;3(1):e000067. doi: 10.1136/bmjdrc-2014-000067. eCollection 2015. PMID: 25767718; PMCID: PMC4352693.
Copy Download .nbib Format: NLM
Share it on

BMJ Open Diabetes Res Care. 2015 Mar 05;3(1):e000067. doi: 10.1136/bmjdrc-2014-000067. eCollection 2015.

Bacterial infections in patients with type 1 diabetes: a 14-year follow-up study.

BMJ open diabetes research & care

Johan R Simonsen, Valma Harjutsalo, Asko Järvinen, Juha Kirveskari, Carol Forsblom, Per-Henrik Groop, Markku Lehto,

Affiliations

  1. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki , Helsinki , Finland ; Division of Nephrology, Department of Medicine , Helsinki University Central Hospital , Helsinki , Finland ; Research Program Unit, Department of Diabetes and Obesity , University of Helsinki , Helsinki , Finland.
  2. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki , Helsinki , Finland ; Division of Nephrology, Department of Medicine , Helsinki University Central Hospital , Helsinki , Finland ; Research Program Unit, Department of Diabetes and Obesity , University of Helsinki , Helsinki , Finland ; Diabetes Prevention Unit , National Institute for Health and Welfare , Helsinki , Finland.
  3. Division of Infectious Diseases, Department of Medicine , Helsinki University Central Hospital , Helsinki , Finland.
  4. Helsinki University Hospital Laboratory, Department of Bacteriology , Helsinki University Central Hospital , Helsinki , Finland.
  5. Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki , Helsinki , Finland ; Division of Nephrology, Department of Medicine , Helsinki University Central Hospital , Helsinki , Finland ; Research Program Unit, Department of Diabetes and Obesity , University of Helsinki , Helsinki , Finland ; Baker IDI Heart and Diabetes Institute , Melbourne, Victoria , Australia.

PMID: 25767718 PMCID: PMC4352693 DOI: 10.1136/bmjdrc-2014-000067

Abstract

OBJECTIVE: This study explored the annual occurrence/incidence of bacterial infections, and their association with chronic hyperglycemia and diabetic nephropathy, in patients with type 1 diabetes.

DESIGN: In a register-based follow-up study, we investigated the frequency of bacterial infections in patients with type 1 diabetes (n=4748) and age-matched and sex-matched non-diabetic control (NDC) subjects (n=12 954) using nationwide register data on antibiotic drug prescription purchases and hospital discharge diagnoses, collected between 1996 and 2009. Diabetic nephropathy was classified based on the urinary albumin excretion rate (AER).

RESULTS: The hospitalization rate due to bacterial infections was higher in patients with diabetes compared with NDCs (rate ratio (RR) 2.30 (95% CI 2.11 to 2.51)). The rate correlated with the severity of diabetic nephropathy: RR for microalbuminuria was 1.23 (0.94 to 1.60), 1.97 (1.49 to 2.61) for macroalbuminuria, 11.2 (8.1 to 15.5) for dialysis, and 6.72 (4.92 to 9.18) for kidney transplant as compared to patients with diabetes and normal AER. The annual number of antibiotic purchases was higher in patients with diabetes (1.00 (1.00 to 1.01)) as compared with NDCs (0.47 (0.46 to 0.47)), RR=1.71 (1.65 to 1.77). Annual antibiotic purchases were 1.18-fold more frequent in patients with microalbuminuria, 1.29-fold with macroalbuminuria, 2.43-fold with dialysis, and 2.74-fold with kidney transplant as compared to patients with normal AER. Each unit of increase in glycated hemoglobin was associated with a 6-10% increase in the number of annual antibiotic purchases.

CONCLUSIONS: The incidence of bacterial infections was significantly higher in patients with type 1 diabetes compared with age-matched and sex-matched NDC subjects, and correlated with the severity of diabetic nephropathy in inpatient and outpatient settings.

Keywords: Glycemic Control; Infectious Disease; Nephropathy

References

  1. Clin Infect Dis. 2005 Aug 1;41(3):281-8 - PubMed
  2. Diabetes Care. 1992 Feb;15(2):256-60 - PubMed
  3. Diabetes Care. 2009 Sep;32(9):1689-93 - PubMed
  4. Diabetes Care. 2011 Jan;34(1):177-80 - PubMed
  5. Arch Intern Med. 2008 Nov 24;168(21):2333-9 - PubMed
  6. Am J Nephrol. 2011;34(4):330-6 - PubMed
  7. Diabetes Care. 2004 May;27(5):1143-7 - PubMed
  8. Diabetes Care. 2003 May;26(5):1553-79 - PubMed
  9. Acta Med Scand. 1982;211(6):463-7 - PubMed
  10. N Engl J Med. 2011 Mar 3;364(9):829-41 - PubMed
  11. J Clin Invest. 2009 Oct;119(10):2868-78 - PubMed
  12. Expert Rev Anti Infect Ther. 2013 Apr;11(4):411-20 - PubMed
  13. Semin Dial. 2006 Jul-Aug;19(4):291-6 - PubMed
  14. Diabet Med. 1997 Jan;14(1):29-34 - PubMed
  15. World J Gastroenterol. 2009 Sep 7;15(33):4137-42 - PubMed
  16. PLoS One. 2013;8(3):e60502 - PubMed
  17. Diabetologia. 2003 Oct;46(10):1402-7 - PubMed
  18. Diabetologia. 2007 Mar;50(3):549-54 - PubMed
  19. J Infect. 2011 Jul;63(1):8-16 - PubMed
  20. Ann Med. 2008;40(8):627-33 - PubMed
  21. Diabetes Care. 2008 Aug;31(8):1541-5 - PubMed
  22. Clin Infect Dis. 2005 Feb 15;40(4):628-31 - PubMed
  23. Curr Diabetes Rev. 2008 Feb;4(1):10-7 - PubMed
  24. Endocrinol Metab Clin North Am. 2013 Dec;42(4):833-47 - PubMed
  25. Diabetes Care. 2001 Jan;24(1):131-53 - PubMed
  26. Diabetes Care. 2003 Feb;26(2):510-3 - PubMed
  27. Diabetes Care. 2001 Jun;24(6):1044-9 - PubMed

Publication Types