People with diabetes who are maintaining healthy HbA1c levels can significantly reduce the risk of being hospitalised due to infections, according to research.
A study conducted by a team from St George’s, University of London found that the poorest blood glucose control among people with diabetes increased the risk of infections, particularly those caused by bacteria.
It is known that diabetes increases the risk of infections, because the condition weakens immune system defences, so researchers wanted to investigate what impact well-managed blood sugar levels had on health outcomes.
They used health data from electronic GP and hospital records to look at infection rates across five years from 2010. The findings were based on an HbA1c review of 85,000 adults aged 40-89 who all had diabetes.
Those with diabetes who had an HbA1c of 97 mmol/mol (11%) or higher had an elevated risk of hospitalisation due to infection compared with those who had optimal HbA1c levels of between 43-53 mmol/mol (6-7%).
As expected, people with diabetes and optimal HbA1c still had a greater infection risk compared with those without diabetes, but the researchers stressed that the risk was kept lower by maintaining healthy blood glucose levels.
Professor Julia Critchley, from the Population Health Research Institute at St George’s, said: “Diabetes patients with the worst control were almost three times as likely to need hospital treatment for an infection compared to those with good control. This was especially high for people with type 1 diabetes and very poor control, who had about 8.5 times higher risk of needing such treatment compared to those without diabetes.
“Across England as a whole, we found that poor diabetes control accounted for about 20-46% of some of the most serious types of infections (sepsis, bone and joint infections, tuberculosis and endocarditis) seen in diabetes patients.”
Higher blood sugar levels were also linked to an increased risk of pneumonia which Prof Critchley added is particularly significant with regard to risk in older people.
The study findings will be published in the Diabetes Care journal in October.
Editor’s note: It’s true that having diabetes increases the risk of complications over the population as a whole, however good blood sugar control – which can be achieved through healthy dietary choices and getting regular exercise – can reduce these risks, helping to ensure people with diabetes can live as normal lives as possible.

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