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Glycaemic control and sepsis risk in adults with type 1 diabetes

Title: Glycaemic control and sepsis risk in adults with type 1 diabetes
Authors: Balintescu, Anca; Lind, Marcus; Andersson Franko, Mikael; Oldner, Anders; Cronhjort, Maria; Eliasson, Björn; Svensen, Christer; Mårtensson, Johan
Source: Diabetes, Obesity and Metabolism ; volume 25, issue 7, page 1942-1949 ; ISSN 1462-8902 1463-1326
Publisher Information: Wiley
Publication Year: 2023
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Aims To study the association between glycated haemoglobin (HbA1c) and sepsis in adults with type 1 diabetes, and to explore the relationship between HbA1c and mortality among individuals who developed sepsis. Materials and Methods We included 33 549 adult individuals with type 1 diabetes recorded in the Swedish National Diabetes Register between January 2005 and December 2015. We used multivariable Cox regression and restricted cubic spline analyses to study the relationship between HbA1c values and sepsis occurrence and association between HbA1c and mortality among those with sepsis. Results In total, 713 (2.1%) individuals developed sepsis during the study period. Compared with the HbA1c reference interval of 48‐52 mmol/mol (6.5‐6.9%), the adjusted hazard ratio for sepsis was: 2.50 [95% confidence interval (CI) 1.18‐5.29] for HbA1c 82 mmol/mol. On multivariable restricted cubic spline analysis, we found a J‐shaped association between HbA1c and sepsis risk, with the lowest risk observed at HbA1c of approximately 53 mmol/mol. We found no association between HbA1c and mortality among those individuals who developed sepsis. Conclusions In our nationwide observational study of adult individuals with type 1 diabetes we found a J‐shaped relationship between HbA1c and risk of sepsis, with the lowest risk at HbA1c levels about 53 mmol/mol (7.0%). HbA1c was not associated with mortality in individuals affected by sepsis.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/dom.15060
Availability: https://doi.org/10.1111/dom.15060; https://onlinelibrary.wiley.com/doi/pdf/10.1111/dom.15060
Rights: http://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.B30FA85E
Database: BASE