{"doi":"10.2337/dc24-1612","title":"Risk of Infection in Older Adults With Type 2 Diabetes With Relaxed Glycemic Control","abstract":"OBJECTIVE: To compare the risk of hospitalization for infection among patients who achieve intensive versus relaxed glycemic control. RESEARCH DESIGN AND METHODS: This retrospective cohort study included adults age ≥65 years with type 2 diabetes from an integrated health care delivery system. Negative binomial models were used to estimate incidence rates and relative risk (RR) of hospitalization for infections (respiratory; genitourinary; skin, soft tissue, and bone; and sepsis), comparing two levels of relaxed (hemoglobin A1c [HbA1c] 7% to <8% and 8% to <9%) with intensive (HbA1c 6% to <7%) glycemic control from 1 January 2019 to 1 March 2020. RESULTS: Among 103,242 older patients (48.5% with HbA1c 6% to <7%, 35.3% with HbA1c 7% to <8%, and 16.1% with HbA1c 8% to <9%), the rate of hospitalization for infections was 51.3 per 1,000 person-years. Compared with HbA1c 6% to <7%, unadjusted risk of hospitalization for infections was significantly elevated among patients with HbA1c 8% to <9% (RR 1.25; 95% CI 1.13, 1.39) but not among patients with HbA1c 7% to <8% (RR 0.99; 95% CI 0.91, 1.08), and the difference became nonsignificant after adjustment. Across categories of infections, the adjusted RR of hospitalization was significantly higher among patients with HbA1c 8% to <9% only for skin, soft tissue, and bone infection (RR 1.33; 95% CI 1.05, 1.69). CONCLUSIONS: Older patients with type 2 diabetes who achieve relaxed glycemic control levels endorsed by clinical guidelines are not at significantly increased risk of hospitalization for most infections, but HbA1c 8% to <9% is associated with an increased risk of hospitalization for skin, soft tissue, and bone infections.","journal":"Diabetes Care","year":2024,"id":460279,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8999,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1114727,"name":"Lisa K. Gilliam","orcid":"0000-0001-7054-1409","position":1,"is_corresponding":false},{"id":313721,"name":"Catherine Lee","orcid":"0000-0003-0008-9052","position":2,"is_corresponding":false},{"id":360986,"name":"Jennifer Y. Liu","orcid":"0000-0002-9702-7415","position":3,"is_corresponding":false},{"id":373990,"name":"Vincent X. Liu","orcid":"0000-0001-6899-9998","position":4,"is_corresponding":false},{"id":360987,"name":"Howard H. Moffet","orcid":"0000-0002-8728-774X","position":5,"is_corresponding":false},{"id":630328,"name":"Melissa M. Parker","orcid":"0000-0002-0113-5041","position":6,"is_corresponding":false},{"id":1101178,"name":"Heidi Zapata","orcid":"0000-0001-9535-7165","position":7,"is_corresponding":false},{"id":360981,"name":"Andrew J. Karter","orcid":"0000-0001-5527-316X","position":8,"is_corresponding":false},{"id":329035,"name":"Kasia J. Lipska","orcid":"0000-0002-0348-742X","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T02:04:03.568045Z","pmid":"39436715","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}