The one in 10 Americans living with type 2 diabetes may be at double the risk of deadly sepsis, especially if they’re under 60, a study suggests.
Researchers in Australia analyzed data from 157,000 adults to explore the connection between type 2 diabetes and sepsis, an extreme reaction to an infection that causes the immune system to attack healthy tissues and organs.
Using patient medical records, the team found twice as many patients with type 2 diabetes were hospitalized for sepsis than people without type 2 diabetes when they were first enrolled in the study.
And over the course of 10 years, nearly 2.5 times the participants with type 2 diabetes developed sepsis compared to non-diabetics.
The diabetics in their 40s were at a 14-fold increased risk of sepsis compared to non-diabetics in the same age range.
Previous research has suggested diabetics may be at an increased risk because they are more likely to develop wounds that don’t heal and can become infected, as high blood sugar damages blood vessels and immune functions needed to close cuts and sores.
High blood sugar also weakens the immune system, making it harder to fight infection.
Additionally, the researchers behind the new study found diabetics were more likely to be older, smokers, insulin users and have heart failure, all of which weaken the immune system and vital organs, making the body a target for sepsis.
Researchers in Australia found type 2 diabetics were up to 14 times more likely than non-diabetics to suffer sepsis (stock image)
Professor Wendy Davis, lead study author and professor at the University of Western Australia, said: ‘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.
‘The best way to prevent sepsis is to quit smoking, normalize high blood sugar and prevent the onset of the micro- and macrovascular complications of diabetes. That’s why this study is important.’
Sepsis is a medical emergency that is caused by the body’s extreme reaction to an infection. It occurs when chemicals released in the bloodstream cause the immune system to go haywire.
Instead of sending infection-fighting white blood cells to attack a foreign invader, it targets healthy tissues and organs such as the limbs and the lungs and kidneys.
Infections that lead to sepsis most commonly start in the skin, urinary tract, lungs, or gastrointestinal tract, but almost any infection can lead to sepsis – starting in wounds as innocuous as paper cuts.
But according to non-profit Sepsis Alliance, half of all cases are from an unknown pathogen.
Sepsis kills 350,000 Americans adults every year and 75,000 children. That’s done death every 90 seconds.
The mortality rate ranges from 10 to 30 percent.
The latest sepsis data from the CDC has shown a slight uptick in sepsis deaths in the last three months, which experts warn could be due to a lack of cohesive sepsis strategy in the US
Sepsis symptoms can closely resemble the flu, so look out for a very high or low temperature, sweating, extreme pain, clammy skin, dizziness, nausea, high heart rate, slurred speech, and confusion
The new study, which is being presented this week at the Annual Meeting of the European Association for the Study of Diabetes (EASD), looked at the medical records of 157,000 adults between 2008 and 2011 from Australia.
Of those, 1,430 had type 2 diabetes. They were matched with 5,720 individuals who were not diabetic based on age, sex and where they lived.
The average participant age was 66, and 52 percent were men.
Researchers tracked their health status until they had a record of sepsis, died, or the study reached its end in 2021.
They found two percent of patients with type 2 diabetes were hospitalized for or with sepsis compared to 0.8 percent of their matched counterparts without diabetes.
And during the average 10-year follow-up time, 12 percent of participants with type 2 diabetes suffered sepsis compared to five percent of their matched counterparts, a 2.3-fold increased risk.
The most notable difference was in diabetics ages 41 to 50, who were at 14.5 times more likely to develop sepsis than non-diabetics.
Janice Holloway, 65, from Arizona, suffered an infection from an unknown pathogen, which quickly turned to sepsis – the first signs of which were a rash on the back of her leg and a high fever.
Sepsis can affect patients of any age, including three-year-old Beauden Baumkitchner, who had both legs amputated after he scraped his knee and contracted staph bacteria
The researchers said people with type 2 diabetes were more likely to be older, male, indigenous, smokers, use insulin, have high blood pressure or have heart failure, all of which are independently associated with a greater risk of sepsis.
According to Sepsis Alliance, slow wound healing seen in diabetics also raises the risk, as contaminants that can seep into the wounds and infect the bloodstream, causing sepsis.
And as glucose builds up in the blood, it attacks blood vessels, leading to poor blood flow to tissues. This makes it more difficult for blood to deliver oxygen to vital organs that are needed to fight infection.
Professor Davis said: ‘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.’
However, the researchers cautioned the study is observational and cannot prove direct causation.