Glycaemic control and sepsis risk in adults with type 1 diabetes
Authors' conclusion
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.
Study context
- Population
- Adults with T1D in the Swedish National Diabetes Register, January 2005–December 2015
- Participants
- 33,549 adults
- Exposure
- HbA1c categories vs reference 48-52 mmol/mol
- Outcome
- Sepsis occurrence
Methodological detailsregistry-based, multivariable Cox regression, restricted cubic spline analysis
- Registry-based
- Multivariable Cox regression
- Restricted cubic spline analysis
Main finding
As reported in the abstract
Sepsis
Each group vs HbA1c 48-52 mmol/molAdjusted hazard ratio (95% CI)
HbA1c <43 mmol/mol
2.50(1.18–5.29)
HbA1c 43-47 mmol/mol
1.88(0.96–3.67)
HbA1c 53-62 mmol/mol
1.78(1.09–2.89)
HbA1c 63-72 mmol/mol
1.86(1.14–3.03)
HbA1c 73-82 mmol/mol
3.15(1.91–5.19)
HbA1c >82 mmol/mol
4.26(2.53–7.16)
- Developed sepsis during the study period
- 713 (2.1%)
Observational data: associations, not effects.
Further findings
- No association between HbA1c and mortality among those who developed sepsis
Original publication
Glycaemic control and sepsis risk in adults with type 1 diabetes. Diabetes Obes Metab. Published 4 April 2023. doi:10.
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