# Clostridioides difficile infection among patients with type 2 diabetes mellitus

## TL;DR

People with type 2 diabetes who get Clostridioides difficile infection face higher mortality and worse outcomes compared to those without diabetes.

## Contribution

This study identifies diabetes as a risk factor for poor outcomes in CDI patients using a large electronic health database.

## Key findings

- Patients with diabetes and CDI had higher all-cause mortality compared to those without diabetes.
- Diabetic CDI patients were older, had more comorbidities, and lower socioeconomic status.
- DM, age, gender, and SES were linked to worse outcomes in CDI patients.

## Abstract

Clostridioides difficile infection (CDI) poses a significant healthcare burden. Patients with diabetes mellitus (DM) are at increased risk of poor outcomes. This study aims to compare CDI outcomes, including mortality, in patients with and without DM. Retrospective data between (2014–2024) from Clalit Health Services (CHS) electronic database were analyzed. Among 2319 patients with confirmed CDI, 1005 had DM, and 1314 did not. DM patients were significantly older (74.5 ± 12.0 vs. 68.6 ± 20.4 years; p < 0.001), more likely to be male (p = 0.029), and disproportionately represented in lower socioeconomic status (SES) groups (30.1% vs. 22.4%; p < 0.001). Additionally, patients with DM had a significantly higher prevalence of comorbidities, with a median Charlson comorbidity Index (CCI) of 7.5 compared to 4.9 (p < 0.001), along with higher serum creatinine levels and lower albumin levels (p < 0.001). All-cause mortality was significantly higher in the DM group (p < 0.001). Deceased patients were notably older (p < 0.001), more likely male, and had lower SES (27% vs. 25.1%, p = 0.028). Patients with DM and CDI exhibited different comorbidities compared to those without diabetes. DM, advanced age, low SES, and male gender are linked to poorer outcomes, including mortality, among patients with CDI. These findings underscore the need for intensive management in patients with diabetes and CDI.