Impact of diabetes and poor glycaemic control on risk of bacteraemia with haemolytic streptococci groups A, B, and G

Thomsen, Reimar Wernich; Riis, Anders H.; Kjeldsen, Sia; Schønheyder, Henrik Carl

doi:10.1016/j.jinf.2011.05.013

Cited by 35 publications

(28 citation statements)

References 43 publications

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“…24 Hyperglycaemia may be a risk factor for infections in patients with type 2 diabetes. [26][27][28][29][30] Therefore, GLDs in theory might influence risk of infections via their different glucose-lowering mechanisms and effectiveness. Hyperglycaemia seems to weaken innate immunity via its negative influence on polymorphonuclear neutrophil function and intracellular bactericidal and opsonic activity.…”

Section: Discussionmentioning

confidence: 99%

Metformin and other glucose-lowering drug initiation and rates of community-based antibiotic use and hospital-treated infections in patients with type 2 diabetes: a Danish nationwide population-based cohort study

et al. 2016

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ObjectiveData on early risk of infection in patients receiving their first treatment for type 2 diabetes are limited. We examined rates of community-based antibiotic use and hospital-treated infection in initiators of metformin and other glucose-lowering drugs (GLDs).DesignPopulation-based cohort study using medical databases.SettingGeneral practice and hospitals in Denmark.Participants131 949 patients with type 2 diabetes who initiated pharmacotherapy with a GLD between 2005 and 2012.ExposureInitial GLD used for pharmacotherapy.Main outcome measuresWe computed rates and adjusted HRs of community-based antibiotic use and hospital-treated infection associated with choice of initial GLD with reference to metformin initiation, using an intention-to-treat approach.ResultsThe rate of community-based antibiotic use was 362 per 1000 patient-years at risk (PYAR) and that for hospital-treated infection was 51 per 1000 PYAR. Compared with metformin, the risk of hospital-treated infection was slightly higher in sulfonylurea initiators (HR 1.12, 95% CI 1.08 to 1.16) and substantially higher in insulin initiators (HR 1.63, 95% CI 1.54 to 1.72) initiators after adjustment for comorbid conditions, comedications and other confounding factors. In contrast, virtually no difference was observed for overall community-based antibiotic use (HR 1.02, 95% CI 1.01 to 1.04, for sulfonylurea initiators; and 1.04, 95% CI 1.01 to 1.07, for insulin initiators).ConclusionsRates of community-based antibiotic treatment and hospitalisation for infection were high in patients receiving their first treatment for type 2 diabetes and differed with the choice of initial GLD used for pharmacotherapy.

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Section: Discussionmentioning

confidence: 99%

Metformin and other glucose-lowering drug initiation and rates of community-based antibiotic use and hospital-treated infections in patients with type 2 diabetes: a Danish nationwide population-based cohort study

et al. 2016

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“…A maior predisposição do paciente com DMT1 e DMT2 a infecções, como também ao estresse, somada às condições anteriormente citadas, são situações que, quando associadas aos diversos mecanismos fisiopatogênicos responsáveis pelo aparecimento dos sintomas gastrointestinais, contribuem tanto para o surgimento como para o agravamento desses sintomas 10,30,35,61 .…”

Section: Alterações Funcionais Gastrointestinais E Medicações Para Trunclassified

Mechanisms and factors associated with gastrointestinal symptoms in patients with diabetes mellitus

Rodrigues

Motta

2012

J Pediatr (Rio J)

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Objectives: To present the main mechanisms that cause gastrointestinal symptoms in patients with diabetes mellitus, their frequency, and controversies as to their occurrence in children and adolescents.Sources: Non-systematic review of the literature conducted in the MEDLINE/PubMed and SciELO databases , as well as relevant book chapters. The most relevant and up-to-date articles on the topic were selected. Summary of the findings:Prevalence of diabetes mellitus has been increasing over the years in many countries. The complications caused by this disease in the digestive system, such as gastrointestinal symptoms (nausea, vomiting, abdominal pain, heartburn, dysphagia, constipation, diarrhea, and fecal incontinence) are well known. The pathogenesis of changes in the gastrointestinal functions in patients with diabetes mellitus is still being investigated at the same time as the role of the enteric nervous system and its neurotransmitters has gained significance. As a consequence of the complications in the digestive system, which damage the enteric nervous system, patients with diabetes mellitus may have specific gastrointestinal motility disorders, some of which may be of great relevance, such as diabetic gastroparesis, constipation, and diarrhea. Gastrointestinal dysfunction increases the morbidity of diabetes mellitus and worsens the quality of life of diabetic individuals. Conclusions:There are few studies addressing these problems in childhood and adolescence. Diabetes mellitus affects the digestive system over the years. Because this condition worsens the quality of life of diabetic individuals and leads to complications, attention must be paid to gastrointestinal symptoms when treating patients with diabetes mellitus. J Pediatr (Rio J). 2012;88(1):17-24:Diabetes mellitus, digestive signs and symptoms, gastrointestinal motility, etiology, child, adolescent. ResumoObjetivos: Apresentar a frequência, os principais fatores causadores dos sintomas gastrointestinais em pacientes portadores do diabetes melito e controvérsias quanto à sua ocorrência em crianças e adolescentes. Fontes dos dados:Revisão não sistemática nas bases de dados MEDLINE/PubMed e SciELO (1983-2011), além de capítulos de livros relevantes. Foram selecionados os artigos mais atuais e representativos do tema. Síntese dos dados:A prevalência do diabetes melito vem aumentando ao longo dos anos em vários países do mundo. No sistema digestório, é conhecida a ocorrência de complicações do diabetes melito, entre elas os sintomas gastrointestinais (náuseas, vômitos, dor abdominal, azia, disfagia, constipação, diarreia e incontinência fecal). A patogênese das alterações das funções gastrointestinais no diabetes melito está ainda sob investigação, e o papel do sistema nervoso entérico e seus neurotransmissores tem ganhado significância. Em decorrência do comprometimento do sistema digestório, com danos ao sistema nervoso entérico, portadores do diabetes melito podem apresentar quadros específicos de distúrbios de motilidade, alguns de grande re...

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“…Patients with diabetes are at increased risk of infections, including soft-tissue infections ( S. aureus, Candidia albicans ) [18, 19], group B streptococcus [20– 22], and genitourinary infections (Enterobacteriaceae) [23, 24]. The immune mechanisms that place patients with diabetes at increased risk of infections, including TB, may also increase the risk of EPTB.…”

Section: Introductionmentioning

confidence: 99%

Diabetes mellitus and extrapulmonary tuberculosis: site distribution and risk of mortality

et al. 2016

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Summary Scarce data exist on the relationship between diabetes and extrapulmonary tuberculosis (EPTB). We evaluated whether diabetes impacts site of TB and risk of death in patients with EPTB. We evaluated a cohort of TB cases from the state of Georgia between 2009 and 2012. Patients aged ≥16 years were classified by diabetes status according to medical records. Site of EPTB was determined by culture and/or state TB classification. Death was defined by all-cause mortality. Of 1325 eligible reported TB cases, 369 (27.8%) had any EPTB including 258 (19.5%) with only EPTB and 111 (8.4%) with pulmonary TB and EPTB. Of all TB cases, 158 had diabetes (11.9%). In multivariable analysis, the odds of any EPTB was similar in patients with and without diabetes [adjusted odds ratio 1.04, 95% confidence interval (CI) 0.70–1.56]. The risk of death was 23.8% in patients with EPTB and diabetes vs. 9.8% in those with no diabetes (P < 0.01); after adjusting for covariates the difference was not significant (aRR 1.19, 95% CI 0.54–2.63). Diabetes was common in patients with EPTB and risk of death was high. Improved understanding of the relationship between diabetes and EPTB is critical to determine the extent that diabetes affects TB diagnosis and clinical management.

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Impact of diabetes and poor glycaemic control on risk of bacteraemia with haemolytic streptococci groups A, B, and G

Cited by 35 publications

References 43 publications

Metformin and other glucose-lowering drug initiation and rates of community-based antibiotic use and hospital-treated infections in patients with type 2 diabetes: a Danish nationwide population-based cohort study

Metformin and other glucose-lowering drug initiation and rates of community-based antibiotic use and hospital-treated infections in patients with type 2 diabetes: a Danish nationwide population-based cohort study

Mechanisms and factors associated with gastrointestinal symptoms in patients with diabetes mellitus

Diabetes mellitus and extrapulmonary tuberculosis: site distribution and risk of mortality

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