The global diabetes epidemic: what does it mean for infectious diseases in tropical countries?

Abstract

Tropical countries are experiencing a substantial rise in type 2 diabetes, which is often undiagnosed or poorly controlled. Since diabetes is a risk factor for many infectious diseases, this increase probably adds to the large infectious disease burden in tropical countries. We reviewed the literature to investigate the interface between diabetes and infections in tropical countries, including the WHO-defined neglected tropical diseases. Although solid data are sparse, patients with diabetes living in tropical countries most likely face increased risks of common and health-care-associated infections, as well as infected foot ulcers, which often lead to amputation. There is strong evidence that diabetes increases the severity of some endemic infections such as tuberculosis, melioidosis, and dengue virus infection. Some HIV and antiparasitic drugs might induce diabetes, whereas helminth infections appear to afford some protection against future diabetes. But there are no or very scarce data for most tropical infections and for possible biological mechanisms underlying associations with diabetes. The rise in diabetes and other non-communicable diseases puts a heavy toll on health systems in tropical countries. On the other hand, complications common to both diabetes and some tropical infections might provide an opportunity for shared services-for example, for eye health (trachoma and onchocerciasis), ulcer care (leprosy), or renal support (schistosomiasis). More research about the interaction of diabetes and infections in tropical countries is needed, and the infectious disease burden in these countries is another reason to step up global efforts to improve prevention and care for diabetes.

Management and outcomes of severe dengue patients presenting with sepsis in a tropical country

“…Our study findings also support previous reports that severe dengue in adult patients with chronic diseases are associated with mortality [11, 12]. Dengue with central nervous system involvement, including aseptic meningitis and encephalitis, is not uncommon and is associated with mortality [32, 33].…”

Alterations in pancreatic β cell function and Trypanosoma cruzi infection: evidence from human and animal studies

“…Comorbidity of a variety of infections and diabetes mellitus (DM) has recently been reported (Dooley and Chaisson 2009; van Crevel et al 2016). Moreover, the soaring rise in DM worldwide but especially in areas where infectious disease is highly endemic, has become a major concern, particularly in determining the management of patients with both diseases (Kumar et al 2016; Siddiqui et al 2016; van Crevel et al 2016).…”

“…Moreover, the soaring rise in DM worldwide but especially in areas where infectious disease is highly endemic, has become a major concern, particularly in determining the management of patients with both diseases (Kumar et al 2016; Siddiqui et al 2016; van Crevel et al 2016). In regard to Chagas disease and to minimize adverse outcomes due to inadequate simultaneous control of infection and diabetes, it is essential to know if a link between T cruzi infection and DM exists.…”

Synergies between Communicable and Noncommunicable Disease Programs to Enhance Global Health Security

“…The detrimental effect of uncontrolled NCDs and NCD risk factors on health security concerns can be illustrated by the examples of diabetes and tobacco use. Diabetes has been shown to increase the severity of endemic diseases such as tuberculosis, melioidosis, dengue, and malaria ( 7 – 9 ). Diabetes also interferes with tuberculosis treatment, threatening the progress of global tuberculosis control in countries with high rates of both illnesses, such as China and India ( 10 , 11 ).…”