Non-Cochrane · prognostic · PM41886636

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

Fu Xue-Lei, Chen Wen-Jun, Zhao Hui-Mei, et al. · Journal of global health · 2026 · PubMed · doi:10.7189/jogh.16.04105

Findings

Population People with type 2 diabetes

42 findings

Not applicable (single-group prevalence/incidence)NonePrevalence of severe periodontitis (probing depth >=6 mm)Pooled prevalence (%) 33.6 [23.7, 44.2]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infection
Sex: female
Pooled prevalence (%) 13 [2.7, 28.4]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infection
Diagnostic criteria: urine culture
Pooled prevalence (%) 14.7 [7.1, 23.2]
GRADE not reported
8 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infection
Continent: North America
Pooled prevalence (%) 8.9 [7.7, 10.1]
GRADE not reported
2 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infection
Diagnostic criteria: ICD-9 codes
Pooled prevalence (%) 9.3 [6.8, 12]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infection
Continent: Asia
Pooled prevalence (%) 14.1 [0, 38.2]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infection
Continent: Europe
Pooled prevalence (%) 16.2 [11.7, 21.1]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infectionPooled prevalence (%) 9.7 [6.5, 13.5]
GRADE not reported
11 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of urinary tract infection
Sex: male
Pooled prevalence (%) 4.9 [3.3, 6.8]
GRADE not reported
2 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of skin infectionPooled prevalence (%) 28.6 [20.7, 37.2]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of pulmonary tuberculosis
Diagnostic criteria: clinical diagnosis (sputum culture, smear, physician diagnosis)
Pooled prevalence (%) 0.3 [0, 2.1]
GRADE not reported
6 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of pulmonary tuberculosis
Diagnostic criteria: ICD-9 codes
Pooled prevalence (%) 1.6 [0, 4]
GRADE not reported
2 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of pulmonary tuberculosis
Continent: Africa
Pooled prevalence (%) 1.4 [0.1, 3.2]
GRADE not reported
2 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of pulmonary tuberculosis
Continent: Asia
Pooled prevalence (%) 0.8 [0, 2.5]
GRADE not reported
6 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of pulmonary tuberculosisPooled prevalence (%) 0.9 [0, 2.3]
GRADE not reported
8 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of upper respiratory tract infection
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 553.6 [12.7, 24149.2]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of lower respiratory tract infection
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 1409.2 [1048.1, 1894.6]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pneumonia
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 107.8 [74.6, 155.9]
GRADE not reported
6 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pneumonia
Mean follow-up 1 to 12 years across incidence cohorts · Continent: Oceania
Pooled incidence rate (per 10 000 person-years) 99 [81, 121]
GRADE not reported
2 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pneumonia
Mean follow-up 1 to 12 years across incidence cohorts · Continent: Europe
Pooled incidence rate (per 10 000 person-years) 134.7 [102.8, 176.5]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pneumonia
Mean follow-up 1 to 12 years across incidence cohorts · Diagnostic criteria: ICD system
Pooled incidence rate (per 10 000 person-years) 108.3 [66.7, 176]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pulmonary tuberculosis
Mean follow-up 1 to 12 years across incidence cohorts · Diagnostic criteria: ICD system
Pooled incidence rate (per 10 000 person-years) 23.4 [14.1, 38.9]
GRADE not reported
7 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pulmonary tuberculosis
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 20.1 [10.8, 37.6]
GRADE not reported
11 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pulmonary tuberculosis
Mean follow-up 1 to 12 years across incidence cohorts · Diagnostic criteria: NTP guidelines
Pooled incidence rate (per 10 000 person-years) 9 [4, 22]
GRADE not reported
2 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pulmonary tuberculosis
Mean follow-up 1 to 12 years across incidence cohorts · Continent: Asia
Pooled incidence rate (per 10 000 person-years) 22.3 [14.7, 33.8]
GRADE not reported
7 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pulmonary tuberculosis
Mean follow-up 1 to 12 years across incidence cohorts · Continent: Europe
Pooled incidence rate (per 10 000 person-years) 2.1 [1.2, 3.7]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of urinary tract infection
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 500.6 [171.3, 1462.6]
GRADE not reported
11 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of urinary tract infection
Mean follow-up 1 to 12 years across incidence cohorts · Sex: male
Pooled incidence rate (per 10 000 person-years) 502.9 [430.6, 587.4]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of urinary tract infection
Mean follow-up 1 to 12 years across incidence cohorts · Diagnostic criteria: ICD system
Pooled incidence rate (per 10 000 person-years) 360.9 [91.1, 1429.8]
GRADE not reported
6 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of urinary tract infection
Mean follow-up 1 to 12 years across incidence cohorts · Continent: North America
Pooled incidence rate (per 10 000 person-years) 638 [535, 762]
GRADE not reported
2 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of urinary tract infection
Mean follow-up 1 to 12 years across incidence cohorts · Sex: female
Pooled incidence rate (per 10 000 person-years) 1379 [627.8, 3029.1]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of urinary tract infection
Mean follow-up 1 to 12 years across incidence cohorts · Continent: Europe
Pooled incidence rate (per 10 000 person-years) 795.1 [428.3, 1475.8]
GRADE not reported
7 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of skin infection
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 664.1 [39.4, 11203.9]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of cellulitis
Mean follow-up 1 to 12 years across incidence cohorts · Diagnostic criteria: ICD-diagnosed
Pooled incidence rate (per 10 000 person-years) 119.5 [22.3, 640.3]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of cellulitis
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 119.5 [22.4, 638.3]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of herpes zoster
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 94.3 [39.7, 224.4]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of sepsis
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 54.7 [39.2, 76.4]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of gastrointestinal tract infection
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 57.1 [34.7, 94.1]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of otitis externa
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 143.1 [80.8, 253.4]
GRADE not reported
3 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of infective endocarditis
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 1.3 [0.8, 2]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NoneIncidence of pyogenic liver abscess
Mean follow-up 1 to 12 years across incidence cohorts
Pooled incidence rate (per 10 000 person-years) 10.8 [8.3, 14]
GRADE not reported
4 studies
Not applicable (single-group prevalence/incidence)NonePrevalence of respiratory tract infectionDue to the lack of relevant data, we could not determine the prevalence of respiratory tract infections
No studies found
0 studies

Included primary studies 70

Open in Studies
StudyYearAlso included byOutcomes it informs hereTrial data
Masi 2014
Association between short leukocyte telomere length, endotoxemia, and severe periodontitis in people with diabetes: a cross-sectional…
PMID:24652728
20141 other reviewnot statednot extracted yet
Ahmed 2009
Prevalence of cutaneous manifestations of diabetes mellitus.
PMID:20524475
2009this review onlynot statednot extracted yet
Al Qurabiy 2022
Urinary tract infection in patients with diabetes mellitus and the role of parental genetics in the emergence of the disease.
PMID:36188660
2022this review onlynot statednot extracted yet
Al-Rubeaan 2013
Prevalence of urinary tract infection and risk factors among Saudi patients with diabetes.
PMID:22956119
2013this review onlynot statednot extracted yet
Antonio-Arques 2022
Glycemic control and the risk of tuberculosis in patients with diabetes: A cohort study in a Mediterranean city.
PMID:36466495
2022this review onlynot statednot extracted yet
Banerjee 2019
Clinical Profile of Asymptomatic Bacteriuria in Type 2 Diabetes Mellitus: An Eastern India Perspective.
PMID:31641630
2019this review onlynot statednot extracted yet
Bartelink 1998
Infections in patients with type 2 diabetes in general practice.
PMID:9699086
1998this review onlynot statednot extracted yet
Borowczyk 2017
Urinary tract infections in postmenopausal women with type 2 diabetes: clinical correlates and quinolone susceptibility.
PMID:28475170
2017this review onlynot statednot extracted yet
Carey 2018
Risk of Infection in Type 1 and Type 2 Diabetes Compared With the General Population: A Matched Cohort Study.
PMID:29330152
2018this review onlynot statednot extracted yet
Carrondo 2020
Potentially preventable urinary tract infection in patients with type 2 diabetes - A hospital-based study.
PMID:32289092
2020this review onlynot statednot extracted yet
Chien 2023
Type 2 Diabetes Mellitus and Periodontitis: Bidirectional Association in Population-based 15-year Retrospective Cohorts.
PMID:37224522
2023this review onlynot statednot extracted yet
Chiţă 2016
Urinary tract infections in Romanian patients with diabetes: prevalence, etiology, and risk factors.
PMID:28031715
2017this review onlynot statednot extracted yet
Dabhi 2020
Screening for prevalence of current TB disease and latent TB infection in type 2 diabetes mellitus patients attending a diabetic clinic in…
PMID:32502176
2020this review onlynot statednot extracted yet
de Miguel-Yanes 2019
Infective endocarditis according to type 2 diabetes mellitus status: an observational study in Spain, 2001-2015.
PMID:31752887
2019this review onlynot statednot extracted yet
Ekeke 2020
Screening diabetes mellitus patients for tuberculosis in Southern Nigeria: A pilot study.
PMID:32153002
2020this review onlynot statednot extracted yet
Feleke 2024
Trends in rates of hospitalisation for infection in people with diabetes and the general population.
PMID:39116262
2024this review onlynot statednot extracted yet
Fernandes 2009
Periodontal disease status in gullah african americans with type 2 diabetes living in South Carolina.
PMID:19563285
2009this review onlynot statednot extracted yet
Ferreira 2018
Incidence and prevalence of hepatitis B in patients with diabetes mellitus in the UK: A population-based cohort study using the UK…
PMID:29220868
2018this review onlynot statednot extracted yet
Fu 2014
Risk characterization for urinary tract infections in subjects with newly diagnosed type 2 diabetes.
PMID:25161100
2014this review onlynot statednot extracted yet
Fu 2021
Metformin as a potential protective therapy against tuberculosis in patients with diabetes mellitus: A retrospective cohort study in a…
PMID:33550691
2021this review onlynot statednot extracted yet
Goswami 2001
Prevalence of urinary tract infection and renal scars in patients with diabetes mellitus.
PMID:11483234
2001this review onlynot statednot extracted yet
Guignard 2014
Risk of herpes zoster among diabetics: a matched cohort study in a US insurance claim database before introduction of vaccination,…
PMID:24973980
2014this review onlynot statednot extracted yet
Hamdan 2015
Urinary tract infections and antimicrobial sensitivity among diabetic patients at Khartoum, Sudan.
PMID:25896611
2015this review onlynot statednot extracted yet
Hamilton 2013
Incidence and predictors of hospitalization for bacterial infection in community-based patients with type 2 diabetes: the fremantle…
PMID:23536910
2013this review onlynot statednot extracted yet
He 2018
Prevalence, risk factors and microorganisms of urinary tract infections in patients with type 2 diabetes mellitus: a retrospective study…
PMID:29520146
2018this review onlynot statednot extracted yet
Heo 2015
Tuberculosis is frequently diagnosed within 12 months of diabetes mellitus.
PMID:26260832
2015this review onlynot statednot extracted yet
Hintao 2007
Root surface and coronal caries in adults with type 2 diabetes mellitus.
PMID:17615017
2007this review onlynot statednot extracted yet
Hirji 2012
Incidence of genital infection among patients with type 2 diabetes in the UK General Practice Research Database.
PMID:22840886
2012this review onlynot statednot extracted yet
Hirji 2012
Incidence of urinary tract infection among patients with type 2 diabetes in the UK General Practice Research Database (GPRD).
PMID:22889712
2012this review onlynot statednot extracted yet
Kang 2014
The effects of statin use on the development of tuberculosis among patients with diabetes mellitus.
PMID:24903944
2014this review onlynot statednot extracted yet
Kim 2025
Association between weight changes and infective endocarditis in patients with diabetes: A nationwide population-based cohort study.
PMID:39572764
2025this review onlynot statednot extracted yet
Ko 2019
A cohort study of age and sex specific risk of pyogenic liver abscess incidence in patients with type 2 diabetes mellitus.
PMID:31027123
2019this review onlynot statednot extracted yet
Kuo 2013
Type 2 diabetes: an independent risk factor for tuberculosis: a nationwide population-based study.
PMID:24236069
2013this review onlynot statednot extracted yet
Lee 2025
Connection between Impaired Fasting Glucose or Type 2 Diabetes Mellitus and Sepsis: A 10-Year Observational Data from the National Health…
PMID:39957312
2025this review onlynot statednot extracted yet
Li 2020
Incidence of pulmonary tuberculosis in Chinese adults with type 2 diabetes: a retrospective cohort study in Shanghai.
PMID:32444672
2020this review onlynot statednot extracted yet
Lin 2015
Screening for pulmonary tuberculosis in type 2 diabetes elderly: a cross-sectional study in a community hospital.
PMID:25572102
2015this review onlynot statednot extracted yet
Lin 2018
Metformin is associated with a lower risk of active tuberculosis in patients with type 2 diabetes.
PMID:29943489
2018this review onlynot statednot extracted yet
Liu 2023
Yield and Efficiency of a Population-Based Mass Tuberculosis Screening Intervention Among Persons With Diabetes in Jiangsu Province, China.
PMID:36869807
2023this review onlynot statednot extracted yet
Lopez-de-Andres 2022
Sex-related disparities in the incidence and outcomes of infective endocarditis according to type 2 diabetes mellitus status in Spain,…
PMID:36180922
2022this review onlynot statednot extracted yet
Malazy 2007
Vulvovaginal candidiasis and its related factors in diabetic women.
PMID:18182346
2007this review onlynot statednot extracted yet
Masood 2016
matched by author and year (probable)
NRthis review onlynot statednot extracted yet
McDonald 2014
New estimates of the burden of acute community-acquired infections among older people with diabetes mellitus: a retrospective cohort study…
PMID:24341529
2014this review onlynot statednot extracted yet
Mor 2016
Rates of Community-based Antibiotic Prescriptions and Hospital-treated Infections in Individuals With and Without Type 2 Diabetes: A…
PMID:27353662
2016this review onlynot statednot extracted yet
Movahed 2007
Increased prevalence of infectious endocarditis in patients with type II diabetes mellitus.
PMID:17967715
2007this review onlynot statednot extracted yet
Muller 2005
Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus.
PMID:16007521
2005this review onlynot statednot extracted yet
Nichols 2017
Prevalence and incidence of urinary tract and genital infections among patients with and without type 2 diabetes.
PMID:28888425
2017this review onlynot statednot extracted yet
Nitta 2017
The number of microvascular complications is associated with an increased risk for severity of periodontitis in type 2 diabetes patients:…
PMID:28129466
2017this review onlynot statednot extracted yet
Pan 2020
Opposite effects of statins on the risk of tuberculosis and herpes zoster in patients with diabetes: A population-based cohort study.
PMID:31633826
2020this review onlynot statednot extracted yet
Pealing 2015
Risk of tuberculosis in patients with diabetes: population based cohort study using the UK Clinical Practice Research Datalink.
PMID:26048371
2015this review onlynot statednot extracted yet
Pham 2018
The interaction among obesity, Type 2 diabetes mellitus, and periodontitis in Vietnamese patients.
PMID:29955389
2018this review onlynot statednot extracted yet
Poirrier 2022
Herpes Zoster Incidence and Burden in Adults With Type 2 Diabetes in the U.S.: A Retrospective Database Analysis.
PMID:36149780
2022this review onlynot statednot extracted yet
Preshaw 2010
Compromised periodontal status in an urban Sri Lankan population with type 2 diabetes.
PMID:20653819
2010this review onlynot statednot extracted yet
Pumerantz 2017
Standardized screening for periodontitis as an integral part of multidisciplinary management of adults with type 2 diabetes: an…
PMID:28761663
2017this review onlynot statednot extracted yet
Qiu 2017
Incident rate and risk factors for tuberculosis among patients with type 2 diabetes: retrospective cohort study in Shanghai, China.
PMID:28449358
2017this review onlynot statednot extracted yet
Rasid 2020
Prevalence and factors associated with cutaneous manifestations of type 2 diabetes mellitus
DOI:10.5603/dk.2020.0049
2020this review onlynot statednot extracted yet
Romano 1998
Skin lesions in diabetes mellitus: prevalence and clinical correlations.
PMID:9597379
1998this review onlynot statednot extracted yet
Saleh 2020
Diabetes Mellitus and Periapical Abscess: A Cross-sectional Study.
PMID:32827508
2020this review onlynot statednot extracted yet
Sasmaz 2004
matched by author and year (probable)
NRthis review onlynot statednot extracted yet
Silva 2010
Periodontitis in individuals with diabetes treated in the public health system of Belo Horizonte, Brazil.
PMID:20683560
2010this review onlynot statednot extracted yet
Sorescu 2024
Characteristics of Urinary Tract Infections in Patients with Diabetes from Timișoara, Romania: Prevalence, Etiology, and Antimicrobial…
PMID:39597055
2024this review onlynot statednot extracted yet
Susanto 2011
Periodontitis prevalence and severity in Indonesians with type 2 diabetes.
PMID:20932156
2011this review onlynot statednot extracted yet
Todescan 2023
High prevalence of periodontitis in children and adolescents with type 2 diabetes.
PMID:35933589
2023this review onlynot statednot extracted yet
Tsai 2002
Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population.
PMID:12000341
2002this review onlynot statednot extracted yet
Tseng 2018
Metformin Decreases Risk of Tuberculosis Infection in Type 2 Diabetes Patients.
PMID:30205606
2018this review onlynot statednot extracted yet
Wachinou 2021
Tuberculosis prevalence and associated factors among persons with diabetes mellitus after intensified case finding in three West African…
PMID:34557300
2021this review onlynot statednot extracted yet
Wang 2018
Thiazolidinediones and reduced risk of incident bacterial abscess in adults with type 2 diabetes: A population-based cohort study.
PMID:29974616
2018this review onlynot statednot extracted yet
Wang 2021
Pyogenic Liver Abscess Risk in Patients With Newly Diagnosed Type 2 Diabetes Mellitus: A Nationwide, Population-Based Cohort Study.
PMID:34055845
2021this review onlynot statednot extracted yet
Wilke 2015
Epidemiology of urinary tract infections in type 2 diabetes mellitus patients: An analysis based on a large sample of 456,586 German T2DM…
PMID:26476473
2015this review onlynot statednot extracted yet
Wu 2021
Type 2 Diabetes Mellitus Increases Peritonsillar Abscess Susceptibility: Real-World Evidence.
PMID:33541035
2021this review onlynot statednot extracted yet
Yu 2014
Disease burden of urinary tract infections among type 2 diabetes mellitus patients in the U.S.
PMID:24929797
2014this review onlynot statednot extracted yet

Overlap with other reviews

Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.

Review question

ElementPlanned (methods)Found (results)
PopulationPeople with type 2 diabetes in population-based samples; excluded special populations (cancer, pregnancy, postoperative, immunodeficiency) and mixed diabetes populations without an identifiable type 2 subgroupPeople with type 2 diabetes (70 studies: 37 prevalence studies, sample size 40 to 293 124; 34 incidence studies, sample size 80 to 5 928 052)
InterventionNot applicable (no intervention)Not applicable (no intervention)
ComparisonNot applicable (no comparator)Not applicable (no comparator)
OutcomesPrevalence (percentage) and incidence (per 10 000 person-years) of clinically confirmed symptomatic infectionsPooled prevalence: severe periodontitis (n=3), urinary tract infection (n=11), skin infection (n=4), pulmonary tuberculosis (n=8). Pooled incidence per 10 000 person-years: upper and lower respiratory tract infection, pneumonia, pulmonary tuberculosis, urinary tract infection, skin infection, cellulitis, herpes zoster, sepsis, gastrointestinal tract infection, otitis externa, infective endocarditis, pyogenic liver abscess
Study designsObservational studies: cross-sectional studies for prevalence and cohort studies for incidence37 prevalence studies and 34 incidence studies (one study contributed to both)
TimingNot specifiedMean follow-up 1 to 12 years in incidence studies