Evaluating Diabetes Mellitus as a Risk Factor for Community-Acquired Infections

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Abstract
Diabetes mellitus (DM) has long been suspected as a risk factor for community-acquired infections, but until recently, there was relatively little evidence to support this hypothesis. Laboratory studies have documented variations in immune function that could lead to a higher risk of infection in persons with DM. However, there are also other differences between persons with DM and those without DM that are important to consider when evaluating the association between DM and risk of infection. Persons with DM interact with the health care system more frequently and more intensively than the general population. They may therefore be more likely to seek medical attention for signs or symptoms of infection. Because the consequences of infection may be more significant in a person with DM, they may also be more likely, after seeking medical attention, to be assigned a diagnosis of infection or to receive a higher level of care for an infectious illness, compared with a person without DM. Lastly, persons with DM may have other comorbid factors, such as renal failure or functional disability, that are associated with an increased risk of infection; therefore, an elevated risk of infection in persons with DM could be a reflection of the higher prevalence of comorbid factors in that population.