People with diabetes are more likely to die from infections than those in the general population, a large Australian study shows.

The study, which included more than one million people with diabetes listed on the Australian diabetes registry between 2000 and 2010, is the first to quantify the risk of death from infections in a large number of people with diabetes, and by specific types of infection.

Results showed that the risk of death from pneumonia, septicaemia and osteomyelitis was significantly higher for those with diabetes compared with the general population.

It also found that the increased risk appears to be greater for type 1 than type 2 diabetes. With septicaemia, for example, the risk of death was five times higher for people with type 1 diabetes than for those with type 2 diabetes.

Although the actual number of deaths due to infection over the 6.7 years follow-up was low, lead researcher Professor Dianna Magliano, from the Baker IDI Heart and Diabetes Institute in Melbourne, said the new findings show that infection is an important cause of death in people with diabetes.

“The absolute risks are low but the relative risks are higher,” she explained. “If you’ve got diabetes your chance of dying from that infection is much higher than if you haven’t.”

The population-based study didn’t look at why infections are more risky for people with diabetes, particularly those with type 1 diabetes, but other studies have suggested that hyperglycaemia may compromise the immune system, while vascular insufficiency and poorly managed disease increases the risk of infection.

Professor Magliano says more research is needed to understand the reasons why those with diabetes may be more likely to get and die from infections. “We also need to ask what can we do once these people get infections: how can we treat them a bit differently to stop them progressing and dying?”