# Prevalence and incidence of infections among people with type 2 diabetes: a systematic review and meta-analysis

## TL;DR

This study finds that people with type 2 diabetes are more likely to suffer from certain infections, with severe periodontitis and lower respiratory infections being the most common.

## Contribution

The study provides updated pooled estimates of infection prevalence and incidence specifically among people with type 2 diabetes.

## Key findings

- Severe periodontitis had the highest pooled prevalence (33.6%) among people with type 2 diabetes.
- Lower respiratory tract infections had the highest pooled incidence (1409.2 per 10,000 person-years).
- Skin and urinary tract infections also showed high prevalence and incidence rates.

## Abstract

Although evidence suggests a greater susceptibility of type 2 diabetes to infections, the prevalence and incidence of different types of infections vary greatly, affecting clinical decision-making. We aimed to estimate the aggregate prevalence and incidence of infections among people with type 2 diabetes.

We searched PubMed, Embase, Web of Science, and Cochrane Library from inception to August 2025. We combined the terms type 2 diabetes, infection, and prevalence/incidence for the search. We included studies with data on infection prevalence (percentage) and/or incidence (number of person-years at risk) among patients with type 2 diabetes. We used the quality-effects model to estimate effects and 95% confidence intervals (CIs).

We included 70 studies in this meta-analysis. Severe periodontitis had the highest pooled prevalence among people with type 2 diabetes (33.6%; 95% CI = 23.7–44.2), followed by skin infections (28.6%; 95% CI = 20.7–37.2) and urinary tract infections (9.7%; 95% CI = 6.5–13.5). Lower respiratory tract infections had the highest pooled incidence per 10 000 person-years (1409.2; 95% CI = 1048.1–1894.6), followed by skin infections (664.1; 95% CI = 39.4–11203.9), upper respiratory tract infections (553.6; 95% CI = 12.7–24149.2) and urinary tract infections (500.6; 95% CI = 171.3–1462.6).

Among people with type 2 diabetes, the prevalence of severe periodontitis and the incidence of lower respiratory tract infections were the highest. We pinpointed recently prevalent high-occurrence infections in type 2 diabetes, helping to update surveillance and control priorities for diabetes care.

PROSPERO: CRD42024489267