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Abstract
This review summarizes data concerning the host resistance to infection in diabetes
and the influence of an acute infection upon the endocrinologic-metabolic status of
the diabetic patient. While it is well known that acute infections lead to difficulty
in controlling blood sugar levels and that infection is the most frequently documented
cause of ketoacidosis, controversy persists as to whether or not patients with diabetes
mellitus are more susceptible to infection than age- and sex-matched nondiabetlc control
subjects. Our data obtained from the charts of 241 diabetic patients who were being
followed as outpatients show a striking direct correlation between the overall prevalence
of infection (p < 0.001) and the mean plasma glucose levels (representing three or
more fasting glucose determinations taken at times when no evidence of infection existed).
There is a significant diminution in intracellular bactericidal activity of leukocytes
with Staphylococcus aureus and Escherichia coli in subjects with poorly controlled
diabetes in comparison with the control group. Serum opsonic activity for both Staph.
aureus and E. coli were significantly lower than in the control subjects. Taken together,
the results from published reports as well as our data suggest to us that good control
of blood sugar in diabetic patients is a desirable goal in the prevention of certain
infections (Candida vaginitis, for example) and to ensure maintenance of normal host
defense mechanisms that determine resistance and response to infection.
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Article Info
Publication History
Accepted:
September 17,
1981
Footnotes
☆This work was supported in part by grants from the NIH (AM 18522), the Upjohn Company and the Herman Goldman Foundation, NIH Research Career Development Awards K04-AM-00089 (Dr. Rayfield) and K04-AI-70847 (Dr. Keusch) and RR-71 Division of Research Resources, Clinical Research Center, Mount Sinai School of Medicine.
Identification
Copyright
© 1982 Published by Elsevier Inc.