Clinical Analysis of Diabetes Mellitus with Infectious Diseases

Abstract

The frequency of diabetes mellitus has risen in Japan as the traditional diet has become increasing Americanized and society has aged. With this has come a rise in infectious diseases and complications elderly diabetic patients and a growing need for appropriate management to maintain their quality of life (QOL) and minimize medical measures. Subjects were 98 diabetic patients-60 men and 38 women hospitalized for intravenous antibiotic treatment of infectious disease from 2002 to 2005. We studied plasma glucose control, plasma and urinary protein levels related to nephropathy, and inflammatory responses to treatment. Subjects were divided into good (under 6.5%), fair (from 6.5% to 8.0%), poor (over 8.0%) and severe (over 10%) groups by HbA1c level on admission. We then compared white blood cell counts, CRP levels and the antibacterial medication periods. Those with poorly controlled plasma glucose control, hypoalbuminuria and interrupted or untreated diabetes required significantly longer antibacterial administration. Insulin was increased by the complications of infection, and decreased as infection ameliorated. Appropriate antibiotic administration is essential for diabetic patients with infectious disease, in addition to early intervention, strict plasma glucose control, continuous treatment, and maintenance of good nutrition. Such treatment improves QOL, shortens antibiotic administration, staves off antibiotic-resistant bacteria, and cuts medical costs.

A Case of Back Abscess and Diabetic Ketoacidosis in a Patient with Type 2 Diabetes Mellitus

“…Patients with DM are susceptible to infection because of decreased migratory ability of neutrophils, decreased phagocytic activity, impaired humoral immunity, increased adherence of microorganisms to diabetic cells, neuropathy, and microangiopathy [1][2][3]11,13]. Moreover, frequency of medical intervention in DM patients is a risk factor for bacteremia; therefore, these patients are particularly vulnerable to infections.…”

“…Patients with type 2 diabetes mellitus (DM) who have poor glycemic control are susceptible to severe bacterial infections and complications such as diabetic ketoacidosis (DKA), which may in turn further exacerbate the bacterial infection [1,2]. Commonly reported bacterial infections in DM patients in Japan have included infections of the respiratory system, kidney and urinary tract, and skin and soft tissue [2]. Deresinski reported that DKA is precipitated or complicated by infections in 75% of the cases.…”