The Etiology of Lower Respiratory Tract Infections in People with Diabetes

Abstract

Patients with diabetes mellitus (DM) are likely to develop many types of infections, which affect the transport of glucose into tissues. Diabetes increases the susceptibility to different kinds of respiratory infections, is often identified as an independent risk factor for developing lower respiratory tract infections. Pulmonary infections caused by Mycobacterium tuberculosis, Staphylococcus aureus, gram-negative bacteria and fungi may occur with an increased frequency, whereas infections due to Streptococcus pneumonia or influenza virus may be associated with increased morbidity and mortality. During lung infection, there are changes in the local and ciliary epithelial lining. Increased susceptibility to pneumococcal infection by people with diabetes is the result of reduced defense capability of antibodies to protein antigens. The relationship between diabetes and pulmonary tuberculosis is well known, and the incidence of tuberculosis in diabetic individuals is 4-5 times greater than among the non-diabetic population. It is thought that malfunction of monocytes in patients with diabetes may contribute to the increased susceptibility to tuberculosis and/or a worse prognosis. Hospitalization of patients with diabetes due to influenza virus or flu-like infections is up to 6 times more likely to occur compared to healthy individuals, also diabetic patients are more likely to be hospitalized due to infection complications. Immunization with influenza and anti-pneumococcal vaccines is recommended to reduce hospitalizations, deaths, and medical expenses. Diabetes, especially the uncontrolled one, predisposes to fungal infection, the most common candidiasis and mucormycosis.

Thorax Computed Tomography Findings in Patients with Erectile Dysfunction

“…Prognosis of pulmonary infections is also poorer. [1718] In agreement with the literature, two of our patients had a previous history of tuberculosis.…”

“…Impaired polymorphonuclear leukocyte functions such as decreased phagocytic activity, chemotaxis, and adherence are an important cause of an increasing disposition to infections in these patients. [17] The incidences of tuberculosis, influenza virus, mucormycosis, and aspiration pneumonia particularly increase. Prognosis of pulmonary infections is also poorer.…”

Comorbid diabetes results in immune dysregulation and enhanced disease severity following MERS-CoV infection

“…Obesity and diabetes have both been identified as significant risk factors for severe disease following lower respiratory tract infections. Diabetes, in particular, is associated with worse disease following MERS-CoV, M. tuberculosis, and B. pseudomallei infection whereas obesity is more often associated with worse disease following influenza infection (24). Both diabetes and obesity result in a dysregulated immune response to respiratory infections (30,(48)(49)(50)(51)(52), but delineating the effects of excess adipose tissue and dyslipidemia associated with obesity compared with the effects of hyperglycemia and excess insulin production associated with T2D on the immune response to infection has not been evaluated.…”

“…The odds ratio of developing severe or lethal disease following MERS-CoV infection when one has comorbid diabetes ranges from 2.47 to 7.24, depending on the study design and population (16)(17)(18)(19)(20)22). Interestingly, diabetes has also been shown to be a risk factor for other lower respiratory tract infections, including Mycobacterium tuberculosis (M. tuberculosis), Burkholderia pseudomallei (B. pseudomallei), and influenza virus (24).…”

An 82-Years-Old Woman with Diabetes Mellitus Type 2, Systemic Hypertension and Dyspnea, Admitted to Hospital with Right Lung Post Viral Pneumonia- A Case Report

“…Pulmonary infections due to Streptococcus pneumonia or influenza virus may be associated with increased morbidity and mortality. Hospitalization of patients with diabetes due to influenza virus or flu-like infections is up to 6 times more likely to occur compared to healthy individuals, also diabetic patients are more likely to be hospitalized due to infection complications (1).…”