Living with type 2 diabetes (T2D) may significantly increase the risk of developing sepsis, a life-threatening complication of infection.
According to a large community-based study from Australia, people with T2D were found to have about twice the risk of sepsis compared to those without the condition, with men and younger adults under 60 particularly vulnerable.
The findings were presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) in Vienna.
Sepsis occurs when the body’s immune response to infection spirals out of control, damaging its own tissues and organs.
It can arise from infections like pneumonia, urinary tract infections, or skin infections, and is one of the leading causes of death worldwide. More than one in ten people who develop sepsis do not survive.
“Earlier studies hinted at an association between type 2 diabetes and sepsis, but our study in a large community-based group confirms a strong relationship,” said lead researcher Professor Wendy Davis from the University of Western Australia.
She emphasized that the study carefully adjusted for other risk factors and competing causes of death, making the link clear.
The researchers followed participants from the Fremantle Diabetes Study Phase II, which began between 2008 and 2011 in a diverse Australian community of 157,000 people.
The study included 1,430 adults with T2D and 5,720 matched individuals without diabetes, similar in age, sex, and location.
Participants were followed for an average of ten years through linked health records, tracking whether they developed sepsis, new diabetes (in the comparison group), or other health outcomes.
At the start, 2% of those with diabetes had already been hospitalized for sepsis, compared to less than 1% of those without.
During the decade of follow-up, nearly 12% of people with diabetes developed sepsis, compared to just 5% of those without. Even after adjusting for factors such as other chronic illnesses, prior hospitalizations, and age, having T2D was still linked to double the risk of sepsis.
The risk was particularly high among younger adults. People with diabetes between 41 and 50 years old had more than a 14-fold increased risk of sepsis compared to those without diabetes in the same age group. Men were also more vulnerable than women, and Indigenous Australians with T2D faced a threefold higher risk compared to non-Indigenous counterparts.
Other factors linked to increased risk included smoking, poor blood sugar control, the use of insulin, high heart rate, certain nerve complications, cerebrovascular disease, and higher levels of a heart failure biomarker known as NT-proBNP. Smoking alone raised the risk of sepsis by 83%.
Professor Davis stressed the importance of prevention: “The best way to reduce sepsis risk is to quit smoking, keep blood sugar under control, and prevent diabetes-related complications.”
Scientists suggest several biological reasons why diabetes may increase sepsis risk. High blood sugar can impair immune system function, making it harder to fight off infections. People with diabetes are also more prone to urinary tract infections, skin infections, and pneumonia, which can escalate into sepsis. Additionally, diabetes-related vascular damage and nerve problems may worsen vulnerability.
The study was observational, meaning it cannot prove that diabetes directly causes sepsis. Researchers note that unmeasured factors and changes in diabetes management over time may also have influenced outcomes. Still, the findings highlight the serious risks linked to diabetes and the need for stronger prevention strategies.
The message is clear: type 2 diabetes not only raises the risk of long-term complications like heart disease but may also double the risk of a sudden, life-threatening emergency like sepsis. Addressing modifiable risk factors—especially smoking and poor glucose control—could help save lives.
