Dengue is a potentially letal mosquito-borne flavivirus disease with about 390 million worldwide infections per year. We have experienced recurrent dengue epidemics in Brazil and Paraguay. We aimed to determine the impact and clinical outcome of diabetes (DM) and hyperglycemia during hospital admission in hospitalized patients for dengue. A total of 294 patients were admitted to a single medical center. Of them,47 (16%) patients had the previous diagnosis of DM (age: 62±12 years, blood glucose [BG]: 238±116 mg/dl), 44 (14.9%) patients had hyperglycemia (BG ≥180 mg/dl) without a prior diagnosis of DM (49±18 years, BG; 165±34 mg/dl) and 214 (73%) had normoglycemia (49±19 years, BG: 110±18 mg/dl). Patients with diabetes and hyperglycemia were older and were more likely to present with severe or hemorrhagic dengue, hemodynamic shock, acute kidney injury (AKI) requiring admission to the ICU and blood transfusion, and longer length of stay. There was a single death in a non-DM patient. Compared to patients with normoglycemia, non-DM patients with hyperglycemia (≥180 mg/dl) had more severe form of dengue with AKI (9.1% vs. 20.7%, OR: 2.61), hemodynamic shock (3.4% vs. 33.3%, OR: 2.61), ICU admission (4.4% vs. 33%, p=0.03) and longer length of hospital stay (4.7 days and 7.1 days, p=0.01). Conclusion: Patients with DM and hyperglycemia were more likely to develop a more severe and hemorrhagic dengue compared to patients with normoglycemia. Because there is no specific dengue therapeutics, prevention is currently limited to vector control measures. A dengue vaccine program could represent a major advance in the control of the disease in patients with diabetes. Disclosure E.D. Bueno Colman: None. Y.A. Pozzo: None. G.E. Umpierrez: Research Support; Self; Sanofi US, Merck & Co., Inc., Novo Nordisk Inc., AstraZeneca. Advisory Panel; Self; Sanofi, Intarcia Therapeutics, Inc.. U.B. Medina: None. A. Benitez: None. S.N. Marin: None.
Introducción: la diabetes mellitus tipo 2 (DM2) es una enfermedad silenciosa que afecta hasta el 20% de nuestra población y de ella, hasta el 50% desconoce que la padece. Esta enfermedad se asocia a una alta prevalencia sobre factores de riesgo como el sobrepeso, la obesidad y la inactividad física. Con frecuencia, la DM2 se diagnostica en forma tardía y a veces genera una gran cantidad de complicaciones asociadas que podría evitarse.
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