{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:14:49Z","timestamp":1788941689426,"version":"build-2803163510"},"reference-count":17,"publisher":"American Diabetes Association","issue":"2","license":[{"start":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T00:00:00Z","timestamp":1611100800000},"content-version":"vor","delay-in-days":50,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>We know that diabetes predisposes to common infections, such as cellulitis and pneumonia. However, the correlation between the level of glycemic control and the rate of infection is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We examined the association between glycemic control in patients with diabetes and the incidence of infection in the entire population of patients with diabetes in a large HMO. During the study period, we first selected an HbA1c test for each patient and then searched for an infection diagnosis in the 60 days that followed the test. A multivariate logistic regression analysis was performed to determine the independent effect of HbA1c on the likelihood of being diagnosed with an infection. We were able to control for many confounders, such as other chronic illness, time since the diagnosis of diabetes, and use of steroids before the infection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We identified 407 cases of cellulitis. Multivariate logistic regressions for cellulitis showed a 1.4-fold increased risk among patients with HbA1c &amp;gt;7.5% (58 mmol\/mol). Factors such as obesity, Parkinson\u2019s disease, peripheral vascular disease, and prior treatment with prednisone predisposed to cellulitis. There was an increase of 12% in the odds of cellulitis for every 1% (11 mmol\/mol) elevation in HbA1c (odds ratio [OR] 1.12; CI 1.05\u20131.19). A similar analysis showed a trend toward an increased risk of pneumonia in patients with HbA1c &amp;gt;7.5% (58 mmol\/mol) (OR 1.1; CI 0.9\u20131.4).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Poor glycemic control was associated in this study with the development of cellulitis. The study also suggests that exposure to oral prednisolone increases the risk of cellulitis, pneumonia, and upper respiratory infection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc19-1393","type":"journal-article","created":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T03:30:23Z","timestamp":1606879823000},"page":"367-372","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":26,"title":["Glycemic Control and Risk of Cellulitis"],"prefix":"10.2337","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0722-7326","authenticated-orcid":false,"given":"Galia","family":"Zacay","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv, Israel"},{"name":"Department of Family Medicine, Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Hershkowitz Sikron","sequence":"additional","affiliation":[{"name":"Clinical Quality Department, Meuhedet Health Maintenance Organization, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony D.","family":"Heymann","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Meuhedet Health Maintenance Organization, Tel Aviv, Israel"},{"name":"Department of Family Medicine, Sackler School of Medicine, University of Tel Aviv, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2020,12,1]]},"reference":[{"key":"2022031300251939400_B1","unstructured":"National Center for Chronic Disease Prevention and Health Promotion\n          . National Diabetes Statistic Report, Estimates of Diabetes and Its Burden in the United States. Accessed 2 March 2019. Available from https:\/\/www.cdc.gov\/diabetes\/pdfs\/data\/statistics\/national-diabetes-statistics-report.pdf"},{"key":"2022031300251939400_B2","unstructured":"Israeli Ministry of Health\n          . National Program for Quality Indicators in Community Healthcare 2014-2016. Accessed 2 March 2019. 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Experience from adverse event reporting in clinical trials","volume":"19","author":"Hammar","year":"2010","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2022031300251939400_B12","doi-asserted-by":"crossref","first-page":"e95","DOI":"10.1016\/j.amepre.2019.04.018","article-title":"Primary care provider encounter cadence and HbA1c control in older patients with diabetes","volume":"57","author":"Dobbins","year":"2019","journal-title":"Am J Prev Med"},{"key":"2022031300251939400_B13","doi-asserted-by":"crossref","first-page":"S27","DOI":"10.1016\/j.cmi.2015.03.024","article-title":"Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections","volume":"21","author":"Dryden","year":"2015","journal-title":"Clin Microbiol Infect"},{"key":"2022031300251939400_B14","doi-asserted-by":"crossref","first-page":"e000359","DOI":"10.1136\/bmjresp-2018-000359","article-title":"Lifestyle and comorbid conditions as risk factors for community-acquired pneumonia in outpatient adults (NEUMO-ES-RISK project)","volume":"6","author":"Rivero-Calle","year":"2019","journal-title":"BMJ Open Respir Res"},{"key":"2022031300251939400_B15","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/resp.13528","article-title":"Why are people with asthma susceptible to pneumonia? A review of factors related to upper airway bacteria","volume":"24","author":"Zaidi","year":"2019","journal-title":"Respirology"},{"key":"2022031300251939400_B16","unstructured":"Advisory Committee on Immunisation Practices - CDC\n          . Prevention of pneumococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP), 1997. Accessed 21 June 2019. 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