Infections represent a critical, under-recognized health hazard for people living with diabetes, according to a major study published in the journal Diabetes. Researchers from City St George’s, University of London found that patients across the diabetes spectrum face significantly higher risks of infection, hospitalization, and death compared to those without the condition, yet these risks remain largely absent from current clinical guidelines.
Why Infections Are a Hidden Danger in Diabetes Care
Infections are not just a complication; for many, they are a primary threat. Data presented at the American Diabetes Association Scientific Sessions in New Orleans reveals that infection is the third most common underlying cause of death in people with type 2 diabetes, trailing only cardiovascular disease and cancer, according to the study led by City St George’s, University of London.
The research team, led by Professor Julia Critchley, analyzed anonymized GP records for over 800,000 people in England over a five-year period. Their findings highlight a stark disparity: people with type 1 diabetes face an 81% higher risk of primary care-managed infections and a 337% higher risk of infection-related hospitalization compared to individuals without diabetes.
In people with type 2 diabetes, fluctuations in blood sugar levels over time—rather than just average levels—are strongly linked to serious infections that require hospital admission.
How Blood Sugar Levels Influence Infection Risk
The study suggests that clinical management must evolve beyond simple average blood sugar targets. In type 1 diabetes, higher blood sugar levels consistently correlate with increased infection risk. However, for those with type 2 diabetes, the volatility of glucose levels is a major factor, meaning patients with seemingly stable average readings may still be at risk if their levels swing significantly between clinic visits.
Professor Julia Critchley emphasizes that these infections are “common, serious, and often preventable.” She argues that failing to address infection risk as a core component of diabetes care is a significant disservice to patients, especially as the global prevalence of diabetes continues to climb.
What Changes Are Experts Calling For?
Researchers are calling for an immediate update to UK, European, and US clinical guidelines. The goal is to embed infection prevention, early recognition, and rapid management directly into standard care protocols. This includes:
- Prioritizing patients with diabetes in primary care triage systems for faster assessment.
- Improving patient messaging to encourage earlier presentation when symptoms appear.
- Explicitly addressing infection risk alongside established metabolic and cardiovascular complications.
The study, funded by the National Institute for Health and Care Research (NIHR), highlights that lower respiratory tract infections like pneumonia are the most common cause for hospital admission in patients with type 1 and type 2 diabetes.
If you are managing diabetes, don’t ignore minor symptoms. Because of the heightened risk profile, healthcare providers recommend seeking early assessment for any signs of infection to prevent complications.
Frequently Asked Questions
Is infection a major risk for those with prediabetes?
Yes. The study found that people with prediabetes face a 35% increased risk of primary care-managed infections and a 33% increased risk of infection-related hospitalization.
What is the most common infection-related death in type 2 diabetes?
Sepsis and lower respiratory tract infections are identified as the most common causes of infection-related death in people with type 2 diabetes.
Why do current guidelines need to be updated?
According to Professor Julia Critchley, current guidelines fail to reflect the substantial burden of illness, hospitalization, and death caused by infections, effectively leaving a major health hazard “hiding in plain sight.”
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