{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T01:33:31Z","timestamp":1791250411393,"version":"4.1.0"},"reference-count":33,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020624","name":"NIHR Nottingham Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020624","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,26]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To establish the incidence of developing diabetes mellitus (DM) post hospitalisation with influenza.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Electronic healthcare records from Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>13\u2009710 adults with a first episode of hospitalised influenza as the primary cause for admission between 1 July 2004 and 1 March 2021 based on ICD-10 codes without pre-existing DM were included. A randomly selected group (a) from CPRD records matched for age, sex and General Practitioner (GP) practice and (b) an unmatched group of hospitalised sepsis patients were used as comparator groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Patients were followed from 1\u2009day after discharge till either DM diagnosis, death or end of GP record. HRs for incidence of DM were calculated using adjusted Cox regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Incidence of DM was 12.5 per 1000 person years. Adjusted HRs (aHR) for developing DM after hospitalised influenza compared with matched controls was 1.54 (95% CI 1.39 to 1.70, p&lt;0.001) and to hospitalised sepsis comparators 1.14 (95% CI 1.03 to 1.26, p=0.013). The greatest risk for developing DM in hospitalised influenza patients was within 90 days of discharge (aHR 2.71 (95% CI 1.94 to 3.77, p&lt;0.001)) compared with matched controls. Risk factors for DM after influenza hospitalisation included being male, pre-existing DM risk, obesity and critical care admission during acute illness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients\u2019 post hospitalisation with influenza had a greater incidence of DM when compared with both matched controls and patients following hospitalisation with sepsis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115391","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:00:59Z","timestamp":1777910459000},"page":"e115391","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence of diabetes mellitus following hospitalisation with influenza: a population-based cohort study in England"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9538-7214","authenticated-orcid":false,"given":"Sophie","family":"Middleton","sequence":"first","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham, UK"},{"name":"Centre for Respiratory Research, Translational Medical Sciences, University of Nottingham School of Medicine, Nottingham, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0914-0416","authenticated-orcid":false,"given":"Tricia M","family":"McKeever","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham, UK"},{"name":"Centre for Respiratory Research, Translational Medical Sciences, University of Nottingham School of Medicine, Nottingham, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0952-0163","authenticated-orcid":false,"given":"Frances S","family":"Grudzinska","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham, UK"},{"name":"Centre for Respiratory Research, Translational Medical Sciences, University of Nottingham School of Medicine, Nottingham, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3799-3758","authenticated-orcid":false,"given":"Yue","family":"Huang","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, Lifespan and population Health, University of Nottingham School of Medicine, Nottingham, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-2249","authenticated-orcid":false,"given":"Charlotte E","family":"Bolton","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham, UK"},{"name":"Centre for Respiratory Research, Translational Medical Sciences, University of Nottingham School of Medicine, Nottingham, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026062608305846000_16.5.e115391.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-020-09553-0","article-title":"Quantifying the direct secondary health care cost of seasonal influenza in England","volume":"20","author":"Moss","year":"2020","journal-title":"BMC Public Health"},{"key":"2026062608305846000_16.5.e115391.2","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/14737167.2024.2427307","article-title":"Secondary healthcare resource utilization and related costs associated with influenza-related hospital admissions in adult patients, England 2016 \u2013 2020","volume":"25","author":"de Courville","year":"2025","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"2026062608305846000_16.5.e115391.3","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1186\/s12890-021-01736-8","article-title":"Hospital admission trends due to respiratory diseases in England and Wales between 1999 and 2019: an ecologic study","volume":"21","author":"Naser","year":"2021","journal-title":"BMC Pulm Med"},{"key":"2026062608305846000_16.5.e115391.4","unstructured":"British Lung Foundation . 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