Type 2 Diabetes Doubles Sepsis Risk, Especially for Men and Younger Adults: Study

About 38 million Americans have diabetes. Which means every 1 in 10 US adults is living with diabetes. Type 2 diabetes contributes to 90% to 95% of these cases. Type 2 diabetes can increase the risk of serious health complications, including heart disease, stroke, kidney disease, nerve damage (neuropathy), and eye damage, which can lead to blindness. However, a new study has found that T2D can even increase the risk of a life-threatening medical emergency. According to a long-term community-based study in Australia, type 2 diabetes (T2D) may double the risk of developing sepsis. The study was presented at this year’s Annual Meeting of the European Association for the Study of Diabetes (EASD), Vienna. Type 2 diabetes and sepsisThe new study found that living with T2D may double the risk of developing sepsis, and those aged younger than 60 years and men are particularly susceptible. The researchers found that smoking, high blood sugar, and other chronic conditions also have a role in the development of sepsis in individuals with type 2 diabetes."An association between type 2 diabetes and sepsis has been noted in some earlier studies. Our study, in a large community-based sample of adults, confirms a strong relationship even after adjustment for a number of potential risk factors and the competing risk of death from unrelated causes, which may have occurred in people at high risk of sepsis before they developed sepsis, thus leading to overestimation of the incidence of sepsis if ignored," lead author Professor Wendy Davis from the University of Western Australia, Australia, said in a statement. “The best way to prevent sepsis is to quit smoking, normalise high blood sugar, and prevent the onset of the micro- and macrovascular complications of diabetes. That’s why this study is important,” she added.What is sepsis?Sepsis is a life-threatening medical emergency that occurs when the body’s immune system has an extreme response to an infection, causing organ dysfunction. This can lead to the body damaging its own tissues and organs, resulting in shock, multiple organ failure, and sometimes death, especially if not recognized early and treated promptly. Sepsis is the most frequent cause of death worldwide, according to the WHO. More than 10% of people who develop sepsis die.How T2D elevate sepsis risk?Previous research had found that those living with T2D have a 2- to 6-fold increased risk of sepsis and worse associated illness and death compared to people without diabetes, but contemporary data are limited.To further explore this, Australian researchers analysed data from the Fremantle Diabetes Study Phase II, a longitudinal observational project in a multi-ethnic urban community of 157,000 in Australia.They identified 1,430 adults with T2D at the time they enrolled between 2008 and 2011 who were matched with 5,720 de-identified individuals without T2D based on age, sex, and postcode. The average age of the participants at enrolment was 66 years, and 52% were men.The researchers tracked their health, using linked health records, until the first record of incident sepsis, new onset diabetes (in the matched cohort), death, or the end of 2021, whichever came first.At enrolment, 2.0% of those with T2D had a prior hospitalisation for/ with sepsis versus 0.8% of their matched counterparts without diabetes. During an average of 10 years of follow-up, 169 (11.8%) participants with T2D and 288 (5.0%) of their matched counterparts developed sepsis.The researchers found that T2D was associated with double the risk of developing sepsis. They also observed that people aged 41-50 years with T2D had a 14.5-fold increased risk of developing sepsis.They also found that people with T2D were more at risk of developing sepsis if they were older, male, of Aboriginal ancestry, current smokers, using insulin, had elevated fasting glucose and a higher heart rate, had distal symmetrical polyneuropathy (nerve disease), cerebrovascular disease, and higher levels of the heart failure biomarker NT-proBNP.Indigenous Australians with T2D were three times as likely to develop sepsis, while smoking was associated with an 83% increased risk of sepsis.“Our study identifies several modifiable risk factors, including smoking, high blood sugar, and complications of diabetes, underscoring that there are steps individuals can take to potentially lower their risk of sepsis,” Professor Davis said.