Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-23T05:36:34.379Z Has data issue: false hasContentIssue false

88 - Diabetes and Infection

from Part XI - The Susceptible Host

Published online by Cambridge University Press:  05 March 2013

Stefan Bughi
Affiliation:
University of Southern California
Sylvia J. Shaw
Affiliation:
University of Southern California
David Schlossberg
Affiliation:
Temple University School of Medicine, Philadelphia
Get access

Summary

Diabetes mellitus is a very prevalent disorder, affecting more than 21 million Americans, with a larger population having prediabetes, such as abnormal glucose tolerance test (˜22 million). More than 90% of diabetic patients have type 2 diabetes. Microvascular and macrovascular complications are related to blood glucose control and disease duration and are more commonly seen in the elderly.

Diabetic patients are also at risk for infections (Table 88.1); approximately 50% of diabetic patients will have at least one hospital admission or outpatient visit for infection. Certain infections (ie, respiratory and foot infections) are overrepresented in the diabetic population and are associated with a higher risk of infection-related mortality.

PREDISPOSING FACTORS TO INFECTION

The abnormalities in host defense mechanisms in diabetic patients are related to uncontrolled diabetes. Hyperglycemia alters host immune response and has been implicated in disorders of immune function by alteration of polymorphonuclear leukocyte (PML) chemotaxis, phagocytosis, and decreased intracellular bactericidal activities. The effect of hyperglycemia on phagocytic activity is associated with an increase in cytosolic calcium and is reversible with the improvement of blood glucose level. There are other metabolic imbalances, which impair the immune system, such as presence of acidemia, reported to be reversed with the normalization of the pH. In addition, presence of chronic inflammatory changes may contribute to the metabolic imbalances (ie, via increased cytokines).

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×