{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:05:07Z","timestamp":1789707907033,"version":"4.0.1"},"reference-count":67,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Diabetes mellitus (DM) is associated with an increased susceptibility to lower respiratory tract infections (LRTIs) and more severe clinical courses, including prolonged hospitalization and increased mortality. During LRTI-related hospitalizations, clinical management often prioritizes the acute respiratory condition, potentially under-recognizing DM-related multimorbidity. We evaluated whether inpatient diabetes specialist consultation is associated with improved outcomes in this high-risk population. Methods: We conducted a retrospective cohort study of 677 adults with DM admitted for LRTI. Specialist consultation was defined as involvement of an endocrinology and\/or diabetes nurse specialist during index hospitalization. Outcomes included length of hospital stay (LOHS) and 90-day mortality. Multivariable zero-truncated negative binomial regression (LOHS) and logistic regression (mortality) were adjusted for age, sex, Charlson Comorbidity Index (CCI), National Early Warning Score (NEWS), and pre-admission insulin use, hypoglycemic events, and admission laboratory parameters. Inverse probability of treatment weighting (IPTW) based on propensity scores was performed as a sensitivity analysis. Results: Among 677 patients, 84 (12.4%) received diabetes specialist consultation. Patients receiving consultation had lower unadjusted 90-day mortality (4.8% vs. 17.5%, p = 0.001) but longer median LOHS (9 vs. 7 days, p &lt; 0.001). After multivariable adjustment, diabetes specialist consultation was associated with lower 90-day mortality (OR 0.23, 95% CI 0.08\u20130.68, p = 0.008) and longer LOHS (IRR 1.27, 95% CI 1.12\u20131.44, p &lt; 0.001). The results were consistent in IPTW sensitivity analyses. Conclusions: In this retrospective cohort of patients with DM hospitalized for LRTIs, inpatient diabetes specialist consultation was associated with lower 90-day mortality, but longer hospital stay. These findings suggest that structured inpatient diabetes specialist involvement may contribute to improved medium-term outcomes in high-risk multimorbid patients. Prospective studies are required to determine causality and evaluate the impact of consultation timing and referral strategies.<\/jats:p>","DOI":"10.3390\/jcm15187173","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:23:53Z","timestamp":1789496633000},"page":"7173","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Inpatient Diabetes Specialist Consultation with Clinical Outcomes in Patients with Diabetes Hospitalized for Lower Respiratory Tract Infections: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Matthias","family":"Domanski","sequence":"first","affiliation":[{"name":"University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland"},{"name":"Faculty of Medicine, University of Basel, CH-4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1229-2181","authenticated-orcid":false,"given":"Fabienne","family":"Jaun","sequence":"additional","affiliation":[{"name":"University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland"},{"name":"Faculty of Medicine, University of Basel, CH-4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5554-0675","authenticated-orcid":false,"given":"Joerg Daniel","family":"Leuppi","sequence":"additional","affiliation":[{"name":"University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland"},{"name":"Faculty of Medicine, University of Basel, CH-4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8605-1893","authenticated-orcid":false,"given":"Maria","family":"Boesing","sequence":"additional","affiliation":[{"name":"University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland"},{"name":"Faculty of Medicine, University of Basel, CH-4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9956-3895","authenticated-orcid":false,"given":"Giorgia","family":"L\u00fcthi-Corridori","sequence":"additional","affiliation":[{"name":"University Institute of Internal Medicine, Cantonal Hospital Baselland, 4410 Liestal, Switzerland"},{"name":"Faculty of Medicine, University of Basel, CH-4056 Basel, Switzerland"},{"name":"Harvard T.H. Chan School of Public Health\u2013Executive and Continuing Professional Education ECPE, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.2337\/dci23-0035","article-title":"Diabetes and Multiple Long-term Conditions: A Review of Our Current Global Health Challenge","volume":"46","author":"Khunti","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.tem.2020.01.007","article-title":"Chronic Diabetes Complications: The Need to Move beyond Classical Concepts","volume":"31","author":"Mauricio","year":"2020","journal-title":"Trends Endocrinol. 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