High absolute risk of severe infections among Indigenous adults in rural northern Australia is amplified by diabetes: a 7 year follow up study

Li, Ming, and McDermott, Robyn (2016) High absolute risk of severe infections among Indigenous adults in rural northern Australia is amplified by diabetes: a 7 year follow up study. Journal of Diabetes and its Complications, 30 (6). pp. 1069-1073.

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Aims: To quantify the risk of hospitalization for infections in Indigenous Australian adults with diabetes in rural and remote communities.

Methods: 2787 Indigenous adults including 396 with diabetes at baseline from 19 communities in North Queensland from 1998 to 2007 were included in the study. Main measures were weight, height, waist circumference, blood pressure, fasting glucose, lipids, self-reported tobacco smoking, alcohol intake and physical activity. Baseline data were linked to hospital separation data using probabilistic linkage. The association between diabetes and hospitalization for all causes and infections was investigated using generalized linear model (GLM) and adjusted for other baseline measurements.

Results: During a median follow up of 7 years, 461 participants were hospitalized with 762 episodes of infection. 277 patients with diabetes (70%) were hospitalized at least once. 40% (110 in 277) were for community acquired infections. Patients with diabetes were twice as likely to be hospitalized for infections as those without diabetes (adjusted risk ratio 2.1, 95% CI 1.6–2.8), especially for urinary tract infections, cellulitis, and septicaemia. Median length of stay was 6 (IQR 3–13) days for diabetes patients compared to 3.4 days (IQR 2–6.4) for those without diabetes (P < 0.001)

Conclusions: In addition to an already high rate of hospitalizations for infections among Indigenous compared to non-Indigenous Australians, diabetes confers an additional risk for severe infections especially urinary tract infection, cellulitis and septicaemia. Recovery is also comparatively slower. Early recognition and management of these infections in the primary care setting may reduce this risk and better control of glycaemia and its risk factors may improve underlying immune dysfunction.

Item ID: 46134
Item Type: Article (Research - C1)
ISSN: 1873-460X
Keywords: infectious diseases incidence; hospitalization; diabetes; Indigenous Australians; follow up study
Additional Information:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Funders: National Health and Medical Research Council (NHMRC), Department of Health and Ageing, Australia (DHA)
Projects and Grants: NHMRC 279402
Date Deposited: 21 Oct 2016 00:02
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450406 Aboriginal and Torres Strait Islander epidemiology @ 50%
42 HEALTH SCIENCES > 4202 Epidemiology > 420202 Disease surveillance @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 50%
92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 50%
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