Surprising Interactions Uncovered Between Diabetes and Sepsis

Patients suffering from diabetes mellitus (DM) are less likely to suffer from acute lung injury (ALI) during severe sepsis, according to a new long-term study.

Researchers from Emory University (Atlanta, GA, USA) conducted a study that cross-referenced sepsis data from the U.S. National Hospital Discharge Survey with DM prevalence data from the U.S. Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) Diabetes Surveillance System, A total of 930 million hospitalizations between 1979 and 2003 were analyzed. The researchers found that among patients with a respiratory source of sepsis, 16% of those with DM developed acute respiratory failure, compared with 23% in people without DM. Among patients with a nonpulmonary source of sepsis, those with DM were still less likely to develop acute respiratory failure when compared with those without DM (6% versus 10%). The researchers speculated that one of the possible mechanisms of protection in patients with DM may be impaired neutrophil function or altered neutrophil-endothelial interactions. Alternatively, patients with DM may be hospitalized earlier in the course of their illness than those with no DM because they learn to be aware of specific signs of infection. Pharmacological aspects of DM care could also influence the development of organ dysfunction, since many medications administered to patients with DM, including insulin and thiazolidinediones, are known to have anti-inflammatory effects, in addition to lowering blood glucose. The study was published online on February 13, 2009, in Critical Care, a publication of BioMed Central.

"We've found that people with DM and sepsis were more likely to develop acute renal failure than people without DM, while being less likely to develop acute respiratory failure,” said lead author Greg Martin, M.D. "Findings like these are important, as accurate identification of populations at risk for different acute organ dysfunctions is crucial to the development of novel therapies for these patients.”

Related Links:
Emory University
U.S. Centers for Disease Control and Prevention