Sepsis Risks Doubles in Diabetes, Study says

By: Chinonso Cynthia Ukah. BNSc, RN, RM, RPHN. Freelance Health Writer. Medically reviewed by: Adebowale Bello. B.Tech Microbiology.

September 23, 2025

A middle-aged African man wearing an orange T-shirt and blue jeans checks his blood sugar level while seated on his bed. A blue open box of test kits lies by his right side. Image credit: Freepik
 

Key Takeaway

• A recent study finds that type 2 diabetes may double your risk of severe life-threatening infection called sepsis
• You are at higher risk if you are a male with diabetes, smoker and under 60 years
• The damage caused by type 2 diabetes to your body’s immune system contributes to the increased the risk of sepsis

Introduction

Type 2 diabetes has been associated with several complications like stroke and diabetic foot, and research has shown that sepsis is yet another notable complication. 

Sepsis is a life threatening condition that occurs when there is an over-reaction of the body to an infection. The source of the infection may be direct as in a soft tissue puncture wound that introduces germs directly into your body, or from a local infection, like a boil, urine, chest or foot infection. If not promptly treated, sepsis may cause multiple organ failure and even death within hours or days. Different types of germs (bacteria, virus, and fungi) may cause sepsis. 

If you have diabetes and develop an infection, the common warning signs of sepsis to watch out for are:

• High fever or unusually low body temperature
• Rapid or difficult breathing 
• Swelling around a cut or wound
• Feeling extremely unwell
• Pale, warm or sweaty skin
• Rashes (sometimes called a “sepsis rash”)
• Confusion or altered mental state
• Severe pain or discomfort
• Reduced urge to urinate
• Vomiting

Go to the nearest hospital or emergency service immediately if you notice any of these signs.

While people living with diabetes are known to be more at risk of infections, this new research shows that their risk of developing sepsis may be much higher than was previously thought.

About the Study

A group of Australian researchers led by Wendy Davis carried out one of the largest community-based studies called the Fremantle Diabetes Study (Phase II). They observed 1,430 adult persons who were living with type 2 diabetes for an average of 10 years and compared them with 5,720 people who did not have diabetes. The researchers used comprehensive health records to track the development of incident sepsis from 2008 to 2021 in an urban community of 157,000 persons. The results of the study were presented at the 61st Annual meeting of the European Association for the Study of Diabetes (EASD) held, September 16 - 19, 2025 in Vienna, Austria.  

What the Study Found

The researchers found that:

• Nearly 12% of people with type 2 diabetes developed sepsis compared to 5% of those without diabetes.

• Type 2 diabetes was associated with twice the risk of sepsis, after adjusting for other risk factors.

• People with type 2 diabetes were hospitalised for sepsis more than twice as often as those without diabetes (2% versus 0.8%).

• Men and people with type 2 diabetes under 60 years of age had the greatest relative increase in the development of sepsis compared to those without type 2 diabetes. In other words, a 45-year-old man with type 2 diabetes is at higher risk of developing sepsis than a 70-year-old man with the same condition.

• Smoking among people with type 2 diabetes was associated with an 83% increased risk of sepsis

While the researchers noted that the study can’t draw a direct cause-and-effect link between type 2 diabetes and sepsis, they concluded that having the condition doubles the risk of sepsis.

Contributory risk factors identified by the researchers, some of which also point to steps that people with diabetes can take to lower their risk of sepsis include: 

• Being male
• Smoking
• Using insulin
• Having poorly controlled blood sugar
• Living with nerve damage (neuropathy)
• Having had a stroke before and
• Showing signs of heart problems.

According to Dr. Davis in a news release, “The best way to prevent sepsis is to quit smoking, normalize high blood sugar and prevent the onset of the micro- and macrovascular complications of diabetes. That’s why this study is important.”

What the Study Means to Africans

While the study was carried out in Australia, its findings are highly relevant to Africans too. Type 2 diabetes is on the rise across Africa, with millions of people unaware that they are living with the condition. Many Africans with diabetes are under the age of 60, and according to the study, at a higher risk of sepsis.

For Africans living with type 2 diabetes, this means it’s not enough to only focus on blood sugar control. Taking active steps to prevent modifiable risk factors that can reduce the odds of developing sepsis is additionally important. 

This means you have to:

1. Stop smoking. Stop smoking and avoid places where people smoke, because secondhand smoke is also harmful.
2. Maintain your blood sugar. Take your prescribed diabetes medications at the right time and follow your healthcare provider’s advice.
3. Avoid skipping meals. If your blood glucose levels are very high or very low, it may weaken your immune system, making it easier for infections to progress to sepsis. Eating regularly helps to keep your blood sugar stable.
4. Keep your blood pressure under control. High blood pressure increases the strain on your heart and blood vessels, raising your risk of complications like sepsis. Take your medications as prescribed and reduce the amount of salt you use in your diet.
5. Watch for early signs of infection. A small wound, fever or unusual pain should never be ignored. Seek medical help early to prevent infection from spreading.
6. Take care of your feet. People with diabetes are more prone to foot ulcers and infections. Clean your feet daily, check for cuts and wear comfortable shoes.
7. Manage other health conditions. If you’ve had a stroke, heart problems or neuropathy, keeping them under control reduces your overall risk of sepsis.
8. Go for regular check-ups. Routine hospital visits help detect complications early and keep your health on track.

Unfortunately, limited access to healthcare in many African communities makes sepsis even more dangerous, because delays in recognising or treating it are likely and worsen outcomes.

Conclusion

Sepsis is life-threatening and can lead to organ failure or death if not treated quickly. A recent US study has revealed that people with type 2 diabetes are twice as likely to develop sepsis compared to those without it. Men with the condition who are under 60 are at higher risk of developing sepsis. This is important and relevant information for Africans, many of whom are young, have type 2 diabetes and are unaware they have the condition.

The takeaway from the study for people living with type 2 diabetes in Africa are; quit smoking, keep your blood sugar under control, pay attention to any signs of infection, and don’t delay going to the hospital if you notice fever, severe pain and discomfort, feel extremely unwell and confused.

Source: 61st EASD Annual Meeting of the European Association for the Study of Diabetes. Diabetologia. 2025;68(Suppl 1):1-754. doi:10.1007/s00125-025-06497-1. Available from here.

Related:

Type 2 Diabetes: What Africans Need to Know

Management of Type 2 Diabetes in Nigeria

9 Tips for Safe Foot Care in African Diabetics

Self-Care for Diabetic Foot Ulcer in Africa – A Nurse’s Perspective  

Published: September 24, 2025

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