New research being presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in Madrid, Spain (9-13 September) suggests that weight loss interventions could reduce the risk of severe cases of flu and other infections in people with diabetes.

The study by Rhian Hopkins and Ethan de Villiers at the University of Exeter Medical School in Exeter, UK, found evidence suggesting that a higher BMI is associated with severe infections.

In contrast, there was no evidence that mild hyperglycemia contributes to the likelihood of a severe infection.

Hopkins stated, “Up to one in three hospitalizations among people with diabetes are due to infections, and individuals with diabetes are twice as likely to be hospitalized with infections compared to the general population. They also face a high risk of readmission.”

Previous studies have found that higher BMI and poor blood sugar control are associated with severe infections. However, these studies have been observational and thus haven’t been able to prove causal links.

“If one or both of these factors can be shown to be causal, it may be possible to design interventions to lower the risk of severe infections in those at high risk, such as people with diabetes.”

The recent study utilized data from the UK Biobank, which contains medical and genetic information on approximately 500,000 individuals in the UK. The study aimed to investigate the impact of elevated BMI and inadequate blood sugar regulation on the likelihood of being hospitalized due to bacterial and viral infections.

A higher BMI was found to be associated with hospitalisation with infections.  Similarly, every five-point increase in BMI was associated with a 32% increase in the likelihood a severe viral infection.

An association between mild hyperglycemia and severe infections was found. The likelihood of hospitalization due to bacterial infection increased by 32% per 10mmol/mol rise in HbA1c, a measure of blood sugar levels.

This suggested that a higher BMI is one of the causes of severe bacterial and viral infections.

However, mild hyperglycaemia did not appear to cause severe infections.

Although the study didn’t focus on individuals with diabetes, Ms Hopkins says that, given their vulnerability to infections, the results may be particularly relevant to them.

She adds: “Infections are a significant cause of death and ill health, particularly in people with diabetes. Anyone admitted to hospital with a severe infection is also at high risk of being admitted again with another. However, we currently have few practical ways to prevent this.

“This study demonstrates that higher BMI is a cause of hospital admission with infection. Clinicians could discuss weight loss options for people with a high BMI at risk of severe infections and readmission to hospital for infection.”

“While this message may be particularly relevant to people with diabetes, it applies more widely.”

Further research is needed to determine if more severe hyperglycaemia is a cause of severe infections.