As of 2021, 537 million adults are living with diabetes, globally. This is expected to reach 800 million in 20 years.1 Patients with diabetes live with a significantly heightened risk of morbidity and mortality from various causes.2 Among such causes are infections. Diabetes is associated with a significantly increased risk of infections like pneumonia and sepsis, due to immune system impairments from hyperglycaemia and metabolic disturbances.3 Pneumonia remains a leading cause of hospitalisation and death in this population, and sepsis is a severe, life-threatening complication.4 Understanding how antidiabetic treatments influence the risk of these infections is crucial for optimising patient outcomes. In recent years, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) have revolutionised type 2 diabetes management by not only improving glycaemic control but also providing cardiovascular and renal benefits.5 However, their impact on infection risk remains less clear. While randomised controlled trials have provided valuable insights, they often lack the generalisability to real-world settings and may lack enough power to capture differences in the risk of rare adverse events.6 7 Therefore, investigating these associations using real-world data is imperative. In this issue of Thorax , Henney et al explore the risk of incident pneumonia and severe sepsis associated with the use of GLP-1 RAs and SGLT2is in patients with diabetes. The authors use data from TriNetX,8 a ‘real-world’ international data set used extensively in research of this nature.9 In a quasi-experimental design, they applied pharmaco-epidemiological methods to compare …

中文翻译：

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超越血糖控制：GLP-1 RAs 和 SGLT2 抑制剂可降低 2 型糖尿病患者患肺炎和脓毒症的风险


截至 2021 年，全球有 5.37 亿成年人患有糖尿病。预计 20 年后将达到 8 亿。1 糖尿病患者因各种原因而发病和死亡的风险显著增加。2 这些原因包括感染。由于高血糖和代谢紊乱导致免疫系统受损，糖尿病与肺炎和败血症等感染的风险显著增加有关.3 肺炎仍然是该人群住院和死亡的主要原因，脓毒症是一种严重的、危及生命的并发症.4 了解抗糖尿病治疗如何影响这些感染的风险对于优化患者预后至关重要。近年来，胰高血糖素样肽-1 受体激动剂 （GLP-1 RAs） 和钠-葡萄糖协同转运蛋白-2 抑制剂 （SGLT2is） 不仅改善了血糖控制，而且提供了心血管和肾脏益处，彻底改变了 2 型糖尿病管理5。虽然随机对照试验提供了有价值的见解，但它们往往缺乏对现实世界环境的普遍性，并且可能缺乏足够的能力来捕捉罕见不良事件风险的差异6 7 因此，使用真实世界数据调查这些关联势在必行。在本期 Thorax 中，Henney 等人探讨了糖尿病患者使用 GLP-1 RAs 和 SGLT2is 相关的肺炎和严重败血症的风险。作者使用了来自 TriNetX 的数据，8 这是一个“真实世界”的国际数据集，广泛用于此类性质的研究.9 在准实验设计中，他们应用药物流行病学方法来比较......