A new study published in The Lancet Regional Health – Europe has shed light on the underestimated contribution of infections to mortality in individuals with Type 2 Diabetes (T2D), urging improvements in health reporting and prevention strategies. The research highlights that infection-related deaths in T2D are significantly underreported, with infections accounting for 13% of all deaths in this group—up from just 1.2% when assessed using traditional coding methods.
The study, which used data from the Clinical Practice Research Datalink (CPRD) database, analyzed health records of over 1.4 million patients in England between 2015 and 2019. It compared the mortality rates of individuals with T2D to those without, revealing that people with diabetes had a 65% higher risk of death. The risk was especially high in younger individuals (ages 41-60), where mortality rates were nearly four times greater compared to non-diabetics.
Key Findings:
Infection-related Mortality: Infections, particularly bone and joint infections and pneumonia, were found to contribute significantly to higher mortality in those with T2D. These infections showed alarmingly high hazard ratios (HRs) for younger individuals—bone and joint infections had an HR of 9.71, and cellulitis had an HR of 6.95.
Underreporting of Sepsis: The study revealed that sepsis, a severe infection-related complication, was often underreported as the cause of death. Despite being listed on death certificates in many cases, sepsis was only recorded as the underlying cause of death in 11% of these instances. When sepsis was included as a contributing factor, the risk of mortality increased to 2.26 times.
Disparities in Mortality: Ethnic differences were also noted, with South Asians exhibiting the highest relative risk for infection-related mortality, while Black individuals had a comparatively lower risk. However, White individuals showed larger absolute mortality differences in younger age groups.
Study Limitations and Implications:
The research underlines the need for better reporting systems to accurately capture infection-related deaths, particularly sepsis, which is often overlooked. Additionally, it highlights the vulnerability of younger individuals with T2D to infections that are typically less common in the general population, emphasizing the need for targeted prevention strategies.
Conclusion:
This study underscores the critical need to prioritize infection prevention, early diagnosis, and timely treatment for people with T2D. By improving reporting standards and healthcare policies, public health systems can help reduce the high rates of preventable mortality and improve overall patient outcomes, especially in younger and more vulnerable populations.
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