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Published online May 16, 2008
Diabetes Care 31:1541-1545, 2008
DOI: 10.2337/dc08-0138
© 2008 by the American Diabetes Association
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Epidemiology/Health Services Research
Original Research

Diabetes, Glycemic Control, and Risk of Hospitalization With Pneumonia

A population-based case-control study

Jette B. Kornum, MD1, Reimar W. Thomsen, MD, PHD1, Anders Riis, MSC1, Hans-Henrik Lervang, MD, PHD2, Henrik C. Schønheyder, MD, DMSC3 and Henrik T. Sørensen, MD, DMSC1

1 Department of Clinical Epidemiology, Aarhus University Hospital, Aalborg, Denmark
2 Department of Endocrinology, Aarhus University Hospital, Aalborg, Denmark
3 Department of Clinical Microbiology, Aarhus University Hospital, Aalborg, Denmark

Corresponding author: Jette B. Kornum, j.kornum{at}rn.dk

OBJECTIVE—To examine whether diabetes is a risk factor for hospitalization with pneumonia and to assess the impact of A1C level on such risk.

RESEARCH DESIGN AND METHODS—In this population-based, case-control study we identified patients with a first-time pneumonia-related hospitalization between 1997 and 2005, using health care databases in northern Denmark. For each case, 10 sex- and age-matched population control subjects were selected from Denmark's Civil Registration System. We used conditional logistic regression to compute relative risk (RR) for pneumonia-related hospitalization among subjects with and without diabetes, controlling for potential confounding factors.

RESULTS—The study included 34,239 patients with a pneumonia-related hospitalization and 342,390 population control subjects. The adjusted RR for pneumonia-related hospitalization among subjects with diabetes was 1.26 (95% CI 1.21–1.31) compared with nondiabetic individuals. The adjusted RR was 4.43 (3.40–5.77) for subjects with type 1 diabetes and 1.23 (1.19–1.28) for subjects with type 2 diabetes. Diabetes duration ≥10 years increased the risk of a pneumonia-related hospitalization (1.37 [1.28–1.47]). Compared with subjects without diabetes, the adjusted RR was 1.22 (1.14–1.30) for diabetic subjects whose A1C level was <7% and 1.60 (1.44–1.76) for diabetic subjects whose A1C level was ≥9%.

CONCLUSIONS—Type 1 and type 2 diabetes are risk factors for a pneumonia-related hospitalization. Poor long-term glycemic control among patients with diabetes clearly increases the risk of hospitalization with pneumonia.


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