DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20195208

Infections in type 2 diabetic patients and its correlations with glycosylated haemoglobin in a tertiary care teaching hospital

Namita Mohapatra, Pratima Soreng, Dibya Prasanna Mohanty, Gurukrushna Mohapatra

Abstract


Background: Diabetes mellitus increases the risk of infections and results in adverse outcomes, but the effect of better glycaemic control has not been thoroughly investigated. Therefore, it was intended to study the various types of infections in Type 2 diabetic patients and its correlation with HbA1c.

Methods: It was a prospective observational study for one year, conducted on Type 2 diabetic patients hospitalized for various causes. Patients with HIV infection or immunocompromised state were excluded. Routine investigations, radiological and culture studies were conducted as required to identify the various infections present. The prevalence of infections was then corelated with blood glucose and HbA1c levels.

Results: Total 105 hospitalized diabetic cases were studied, out of which infections were detected in 72 (68.6%) patients, which was found to be statistically significant. The most common infection detected was UTI (45.8%). Among the UTI patients, E. coli was the most common organism isolated (52.3%) followed by Enterococcus (19%), Pseudomonas (19%) and Citrobacter (9.5%). Infections occurred in 61 (82.4%) patients with HbA1C >6.5% and in 11 (35.5%) patients with HbA1C <6.5%, which was found to be statistically significant.

Conclusions: Diabetes increases the risk of infections. Urinary tract infection is the most common infection, affecting the females predominantly. An association between current hyperglycaemia, glycosylated haemoglobin  and infection risk in type 2 diabetes patients was found.


Keywords


Blood glucose, Diabetes mellitus, Infections, Glycosylated haemoglobin

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References


World Health Organization, Global Report on Diabetes. Geneva, 2016. Available at: https://apps.who.int/iris/bitstream/handle/10665/204871/9789241565257_eng. Assessed 04 November 2019.

Stoeckle M, Kaech C, Trampuz A, Zimmerli W. The role of diabetes mellitus in patients with bloodstream infections. Swiss Medical Weekly. 2008 Sep 6;138(35):512-9.

Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocrinol Metab. 2012 Mar;16(Suppl1):S27-S36.

Muller LM, Gorter KJ, Hak E, Goudzwaard WL, Schellevis FG, Hoepelman AI, et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clini Infect Dis. 2005 Aug 1;41(3):281-8.

Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes/Metab Res Reviews. 2007 Jan;23(1):3-13.

Carey IM, Critchley JA, DeWilde S, Harris T, Hosking FJ, Cook DG. Risk of infection in type 1 and type 2 diabetes compared with the general population: a matched cohort study. Diabetes Care. 2018 Mar 1;41(3):513-21.

Mor A, Dekkers OM, Nielsen JS, Beck-Nielsen H, Sørensen HT, Thomsen RW. Impact of glycemic control on risk of infections in patients with type 2 diabetes: a population-based cohort study. Am J Epidemiol. 2017 Jun 9;186(2):227-36.

Burekovic A, Dizdarevic-Bostandzic A, Godinjak A. Poorly regulated blood glucose in diabetic patients-Predictor of acute infections. Medical Archives. 2014 Jun;68(3):163-6.

Saleem M, Daniel B. Prevalence of urinary tract infection among patients with diabetes in Bangalore city. Inter J Emerging Sci. 2011 Jun 1;1(2):133-42.

Chinwe IA, Obeagu EI, Chukwudi A, Priscilla EU. Prevalence of Urinary Tract Infection in Diabetic patients attending Umuahia Health care facilities J Bio Innov. 2016;5(1):68-82.

Shankar EM, Mohan V, Premalatha G, Srinivasan RS, Usha AR. Bacterial etiology of diabetic foot infections in South India. Europ J Internal Med. 2005 Dec 1;16(8):567-70.

Aswani SM, Chandrashekar UK, Shivashankara KN, Pruthvi BC. Clinical profile of urinary tract infections in diabetics and non-diabetics. Australasian Medica J. 2014;7(1):29-34.

Zubair M, Malik A, Ahmad J. Glycosylated hemoglobin in diabetic foot and its correlation with clinical variables in a north Indian tertiary care hospital. J Diabetes Metab. 2015 Jul 1;6(571):2.

Critchley JA, Carey IM, Harris T, DeWilde S, Hosking FJ, Cook DG. Glycemic control and risk of infections among people with type 1 or type 2 diabetes in a large primary care cohort study. Diabetes Care. 2018 Oct 1;41(10):2127-35.