Study Shows Weight Loss May Decrease Severe Infection Risk in Diabetic Patients

New research indicates that weight loss therapies could diminish the risk of severe flu cases and other infections for individuals with diabetes.

This study will be presented at the upcoming European Association for the Study of Diabetes (EASD) annual meeting in Madrid, Spain, from September 9 to 13.

The research team, led by Rhian Hopkins and Ethan de Villiers from the University of Exeter in the UK, highlights a connection between a higher Body Mass Index (BMI) and severe illnesses. In contrast, there is no indication that mild hyperglycemia increases the risk of severe infections.

Hopkins remarked, "Up to one in three hospitalizations among people with diabetes are due to infections. These individuals are twice as likely to be hospitalized for infections compared to the general population and face a higher risk of readmission."

Earlier studies have established that elevated BMI and poor blood sugar control correlate with severe infections. However, these observational studies have not definitively established a causal relationship between them.

Should it be proven that either high BMI or poor blood sugar control causes severe infections, interventions could be designed to mitigate the risk, particularly for high-risk individuals like those with diabetes.

The recent study analyzed data from the UK Biobank, which contains medical and genetic information from around 500,000 UK residents. Researchers evaluated the impact of high BMI and blood sugar control on hospitalizations for bacterial and viral infections.

Among the 486,924 participants, individuals were categorized into three groups: hospitalizations for bacterial infections (n=64,005), hospitalizations for viral infections (n=14,562), and an infection-free control group (n=408,357).

Findings revealed that elevated BMI correlates with increased infection-related hospitalizations. Specifically, the odds of being hospitalized for a bacterial infection surged by 30% with every 5-point increase in BMI (e.g., from 30 kg/m² to 35 kg/m²).

Additionally, each 5-point rise in BMI led to a 32% augmented likelihood of struggling with severe viral infections.

The research also connected mild hyperglycemia to severe infections. The probability of hospitalization for bacterial infections increased by 32% for each 10 mmol/mol rise in HbA1c, a standard measure for blood sugar levels. Similarly, a 10 mmol/mol rise in HbA1c boosted the odds of severe viral infections by 29%.

Using Mendelian randomization — a method employing genetic data to determine causality — the team aimed to clarify these relationships. Results indicated that high BMI likely contributes to severe bacterial and viral infections. Nonetheless, mild hyperglycemia did not constitute a causal risk factor for severe infections.

Although the study did not specifically target diabetic patients, it remains relevant due to their high vulnerability to infections, according to Hopkins.

She emphasizes, "Infections represent a significant cause of morbidity and mortality, particularly for those living with diabetes. Patients admitted for severe infections are at greater risk for subsequent readmissions. Currently, we have few effective preventive interventions."

"This research highlights that high BMI is a causal factor behind in-hospital infection admissions. Therefore, clinicians should discuss weight loss solutions for patients with high BMI who are vulnerable to severe infections and potential readmissions."

"This message, while particularly pertinent for those with diabetes, is applicable to the wider population as well."

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