Endocrine Abstracts

Background and Aims: Acute and chronic infectious diseases appear to be more prevalent among patients having diabetes mellitus. Infections associated with diabetes could be particularly serious increasing morbimortality and treatment costs. Diabetic patients’ predisposition to infections could be explained by the hyperglycemic environment impairing immune function. Other factors my contribute such as degenerative complications, for example autonomic neuropathy could decrease gastrointestinal and urinary motility.

Aim: The aim of this work is to assess the prevalence and type of infectious diseases among a type 2 diabetic hospitalized population.

Materials and Methods: We conducted a retrospective study including all type2 diabetics hospitalized in the Diabetology-Endocrinology department during the period 2018-2021.

Results: A total number of 357 type 2 diabetic patients was hospitalized during the study period. The average age was of 52.58 years [17-84]. A female predominance was noted (65.26%). Diabetic complications were distributed as following: 31.65% of patients had cardiovascular diseases, 33.05% a sensory polyneuritis, 29% a diabetic retinopathy, 10.92% a diabetic nephropathy and 8.68% an autonomic neuropathy. The prevalence of infections was of 26.61% with diabetic infected foot (8.96%) and urinary tract infection (7.5% of patients whose pyelonephritis in 85% of cases) as the main ones. Skin infections were present in 6.7% of cases of which the main was erysipelas (2.5% of all patients). Three patients had mycoses (0.8%) and a similar number had shingle. Measles, anthrax, furunculosis and skin wound infection were present in one case for each (0.44%). Respiratory infections affected 3.08% of patients: pneumonia was diagnosed in 1.96% and tracheobronchitis in 1.12% of the study population. Six patients (1.6%) had dental infections. Two patients (0.56%) had osteoarticular infections. A similar number of patients (n=2, 0.56%) had a digestive system infection. Regarding severity, a sepsis was noted in 3 cases (0.8%) (of which 2 urinary tract infections). Infection was the revealing factor of diabetes among 31.42% of the cases of recent diabetes.

Conclusion: Infection could be the first manifestation of diabetes mellitus, therefore patients consulting for acute infections and having risk factors for type 2 diabetes should be screened for hyperglycemia and for other metabolic features. Coexistence of diabetes and infection may precipitate metabolic acute complications, such as hypoglycemia, Ketosis, ketoacidosis and hyperosmolar states. Adopting a healthy life style and having a better glycemic control could reduce diabetes’ morbidity including the related one to infections.