Undiagnosed diabetes mellitus in community-acquired pneumonia: A prospective cohort study

Andreas Vestergaard Jensen; Daniel Faurholt-Jepsen; Gertrud Baunbæk Egelund; Stine Bang Andersen; Pelle Trier Petersen; Thomas Benfield; Martin Witzenrath; Gernot Rohde; Pernille Ravn; German Community-Acquired Pneumonia Competence Network (CAPNETZ)

doi:10.1093/cid/cix703

Undiagnosed diabetes mellitus in community-acquired pneumonia: A prospective cohort study

Andreas Vestergaard Jensen, Daniel Faurholt-Jepsen, Gertrud Baunbæk Egelund, Stine Bang Andersen, Pelle Trier Petersen, Thomas Benfield, Martin Witzenrath, Gernot Rohde, Pernille Ravn, German Community-Acquired Pneumonia Competence Network (CAPNETZ)

7 Citations (Scopus)

Abstract

Background: Diabetes mellitus is an important risk factor for community-acquired pneumonia, whereas the prevalence of undiagnosed diabetes mellitus and prediabetes in patients with community-acquired pneumonia is largely unknown. We aimed to determine the prevalence of prediabetes, undiagnosed diabetes mellitus, and risk factors associated with undiagnosed diabetes mellitus in a large European community-acquired pneumonia cohort.

Methods: This was a multicenter prospective cohort study of hospitals and private practices in Germany and Austria encompassing 1961 adults with community-acquired pneumonia included in the German Community-Acquired Pneumonia Competence Network (CAPNETZ) study between 2007 and 2014. The prevalence of undiagnosed diabetes mellitus and prediabetes was estimated based on hemoglobin A1c measurements. Logistic regression was used to assess risk factors for undiagnosed diabetes mellitus.

Results: Fifteen percent of patients had known diabetes mellitus. Among patients without known diabetes mellitus, 5.0% had undiagnosed diabetes mellitus and 37.5% had prediabetes. Male sex (odds ratio [OR], 2.45 [95% confidence interval {CI}, 1.35-4.45]), body mass index ≥25 kg/m2 (OR, 2.64 [95% CI, 1.48-4.72]), and hyperglycemia at admission (6-11 mM: OR, 2.93 [95% CI, 1.54-5.60] and ≥11 mM: OR, 44.76 [95% CI, 17.58-113.98]) were associated with undiagnosed diabetes mellitus. Patients with undiagnosed diabetes mellitus had a higher 180-day mortality rate compared to patients without diabetes mellitus (12.1% vs 3.8%, respectively; P = .001).

Conclusions: Undiagnosed diabetes mellitus was prevalent among community-acquired pneumonia. Male sex, overweight, and hyperglycemia at admission were associated with undiagnosed diabetes mellitus. The long-term mortality among patients with undiagnosed diabetes mellitus was high compared to patients without diabetes mellitus.

Original language	English
Journal	Clinical Infectious Diseases
Volume	65
Issue number	12
Pages (from-to)	2091-2098
Number of pages	8
ISSN	1058-4838
DOIs	https://doi.org/10.1093/cid/cix703
Publication status	Published - 15 Dec 2017

Keywords

Faculty of Science
Community-acquired pneumonia
Undiagnosed diabetes mellitus
Risk factors
Mortality

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Jensen, A. V., Faurholt-Jepsen, D., Egelund, G. B., Andersen, S. B., Petersen, P. T., Benfield, T., Witzenrath, M., Rohde, G., Ravn, P., & German Community-Acquired Pneumonia Competence Network (CAPNETZ) (2017). Undiagnosed diabetes mellitus in community-acquired pneumonia: A prospective cohort study. Clinical Infectious Diseases, 65(12), 2091-2098. https://doi.org/10.1093/cid/cix703

Jensen, AV, Faurholt-Jepsen, D, Egelund, GB, Andersen, SB, Petersen, PT, Benfield, T, Witzenrath, M, Rohde, G, Ravn, P & German Community-Acquired Pneumonia Competence Network (CAPNETZ) 2017, 'Undiagnosed diabetes mellitus in community-acquired pneumonia: A prospective cohort study', Clinical Infectious Diseases, vol. 65, no. 12, pp. 2091-2098. https://doi.org/10.1093/cid/cix703

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abstract = "Background: Diabetes mellitus is an important risk factor for community-acquired pneumonia, whereas the prevalence of undiagnosed diabetes mellitus and prediabetes in patients with community-acquired pneumonia is largely unknown. We aimed to determine the prevalence of prediabetes, undiagnosed diabetes mellitus, and risk factors associated with undiagnosed diabetes mellitus in a large European community-acquired pneumonia cohort.Methods: This was a multicenter prospective cohort study of hospitals and private practices in Germany and Austria encompassing 1961 adults with community-acquired pneumonia included in the German Community-Acquired Pneumonia Competence Network (CAPNETZ) study between 2007 and 2014. The prevalence of undiagnosed diabetes mellitus and prediabetes was estimated based on hemoglobin A1c measurements. Logistic regression was used to assess risk factors for undiagnosed diabetes mellitus.Results: Fifteen percent of patients had known diabetes mellitus. Among patients without known diabetes mellitus, 5.0% had undiagnosed diabetes mellitus and 37.5% had prediabetes. Male sex (odds ratio [OR], 2.45 [95% confidence interval {CI}, 1.35-4.45]), body mass index ≥25 kg/m2 (OR, 2.64 [95% CI, 1.48-4.72]), and hyperglycemia at admission (6-11 mM: OR, 2.93 [95% CI, 1.54-5.60] and ≥11 mM: OR, 44.76 [95% CI, 17.58-113.98]) were associated with undiagnosed diabetes mellitus. Patients with undiagnosed diabetes mellitus had a higher 180-day mortality rate compared to patients without diabetes mellitus (12.1% vs 3.8%, respectively; P = .001).Conclusions: Undiagnosed diabetes mellitus was prevalent among community-acquired pneumonia. Male sex, overweight, and hyperglycemia at admission were associated with undiagnosed diabetes mellitus. The long-term mortality among patients with undiagnosed diabetes mellitus was high compared to patients without diabetes mellitus.",

keywords = "Faculty of Science, Community-acquired pneumonia, Undiagnosed diabetes mellitus, Risk factors, Mortality",

author = "Jensen, {Andreas Vestergaard} and Daniel Faurholt-Jepsen and Egelund, {Gertrud Baunb{\ae}k} and Andersen, {Stine Bang} and Petersen, {Pelle Trier} and Thomas Benfield and Martin Witzenrath and Gernot Rohde and Pernille Ravn and {German Community-Acquired Pneumonia Competence Network (CAPNETZ)}",

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T1 - Undiagnosed diabetes mellitus in community-acquired pneumonia

T2 - A prospective cohort study

AU - Jensen, Andreas Vestergaard

AU - Faurholt-Jepsen, Daniel

AU - Egelund, Gertrud Baunbæk

AU - Andersen, Stine Bang

AU - Petersen, Pelle Trier

AU - Benfield, Thomas

AU - Witzenrath, Martin

AU - Rohde, Gernot

AU - Ravn, Pernille

AU - German Community-Acquired Pneumonia Competence Network (CAPNETZ)

N1 - CURIS 2017 NEXS 390

PY - 2017/12/15

Y1 - 2017/12/15

N2 - Background: Diabetes mellitus is an important risk factor for community-acquired pneumonia, whereas the prevalence of undiagnosed diabetes mellitus and prediabetes in patients with community-acquired pneumonia is largely unknown. We aimed to determine the prevalence of prediabetes, undiagnosed diabetes mellitus, and risk factors associated with undiagnosed diabetes mellitus in a large European community-acquired pneumonia cohort.Methods: This was a multicenter prospective cohort study of hospitals and private practices in Germany and Austria encompassing 1961 adults with community-acquired pneumonia included in the German Community-Acquired Pneumonia Competence Network (CAPNETZ) study between 2007 and 2014. The prevalence of undiagnosed diabetes mellitus and prediabetes was estimated based on hemoglobin A1c measurements. Logistic regression was used to assess risk factors for undiagnosed diabetes mellitus.Results: Fifteen percent of patients had known diabetes mellitus. Among patients without known diabetes mellitus, 5.0% had undiagnosed diabetes mellitus and 37.5% had prediabetes. Male sex (odds ratio [OR], 2.45 [95% confidence interval {CI}, 1.35-4.45]), body mass index ≥25 kg/m2 (OR, 2.64 [95% CI, 1.48-4.72]), and hyperglycemia at admission (6-11 mM: OR, 2.93 [95% CI, 1.54-5.60] and ≥11 mM: OR, 44.76 [95% CI, 17.58-113.98]) were associated with undiagnosed diabetes mellitus. Patients with undiagnosed diabetes mellitus had a higher 180-day mortality rate compared to patients without diabetes mellitus (12.1% vs 3.8%, respectively; P = .001).Conclusions: Undiagnosed diabetes mellitus was prevalent among community-acquired pneumonia. Male sex, overweight, and hyperglycemia at admission were associated with undiagnosed diabetes mellitus. The long-term mortality among patients with undiagnosed diabetes mellitus was high compared to patients without diabetes mellitus.

AB - Background: Diabetes mellitus is an important risk factor for community-acquired pneumonia, whereas the prevalence of undiagnosed diabetes mellitus and prediabetes in patients with community-acquired pneumonia is largely unknown. We aimed to determine the prevalence of prediabetes, undiagnosed diabetes mellitus, and risk factors associated with undiagnosed diabetes mellitus in a large European community-acquired pneumonia cohort.Methods: This was a multicenter prospective cohort study of hospitals and private practices in Germany and Austria encompassing 1961 adults with community-acquired pneumonia included in the German Community-Acquired Pneumonia Competence Network (CAPNETZ) study between 2007 and 2014. The prevalence of undiagnosed diabetes mellitus and prediabetes was estimated based on hemoglobin A1c measurements. Logistic regression was used to assess risk factors for undiagnosed diabetes mellitus.Results: Fifteen percent of patients had known diabetes mellitus. Among patients without known diabetes mellitus, 5.0% had undiagnosed diabetes mellitus and 37.5% had prediabetes. Male sex (odds ratio [OR], 2.45 [95% confidence interval {CI}, 1.35-4.45]), body mass index ≥25 kg/m2 (OR, 2.64 [95% CI, 1.48-4.72]), and hyperglycemia at admission (6-11 mM: OR, 2.93 [95% CI, 1.54-5.60] and ≥11 mM: OR, 44.76 [95% CI, 17.58-113.98]) were associated with undiagnosed diabetes mellitus. Patients with undiagnosed diabetes mellitus had a higher 180-day mortality rate compared to patients without diabetes mellitus (12.1% vs 3.8%, respectively; P = .001).Conclusions: Undiagnosed diabetes mellitus was prevalent among community-acquired pneumonia. Male sex, overweight, and hyperglycemia at admission were associated with undiagnosed diabetes mellitus. The long-term mortality among patients with undiagnosed diabetes mellitus was high compared to patients without diabetes mellitus.

KW - Faculty of Science

KW - Community-acquired pneumonia

KW - Undiagnosed diabetes mellitus

KW - Risk factors

KW - Mortality

U2 - 10.1093/cid/cix703

DO - 10.1093/cid/cix703

M3 - Journal article

C2 - 29095981

SN - 1058-4838

VL - 65

SP - 2091

EP - 2098

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 12

ER -

Undiagnosed diabetes mellitus in community-acquired pneumonia: A prospective cohort study

Abstract

Keywords

UN SDGs

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