Infections in patients with diabetes mellitus: A review of pathogenesis

Area of Science:

• Infectious Diseases
• Endocrinology
• Immunology

Background:

• Diabetes mellitus is associated with a higher incidence and severity of infections, leading to increased morbidity and mortality.
• Hyperglycemia in diabetes impairs immune function, affecting neutrophils, antioxidant systems, and humoral immunity.
• Diabetic patients experience complications like micro/macro-angiopathies, neuropathy, and dysmotility, further increasing infection susceptibility.

Purpose of the Study:

• To elucidate the mechanisms linking diabetes mellitus and increased infection risk.
• To highlight specific infections prevalent in diabetic individuals.
• To emphasize the role of infections as potential initial manifestations or triggers for diabetic complications.

Main Methods:

• Review of existing literature on diabetes and infectious diseases.
• Analysis of factors contributing to immune dysfunction in hyperglycemia.
• Identification of common and specific infections in diabetic patients.

Main Results:

• Hyperglycemia-induced immune dysfunction, vascular complications, and neuropathy contribute to increased infection rates.
• Diabetic foot infections, malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis are notably common.
• Infections can be the first sign of diabetes or precipitate acute complications like ketoacidosis.

Conclusions:

• Infectious diseases pose a significant threat to patients with diabetes mellitus.
• Vaccination against pneumococcal and influenza infections is a key preventive strategy.
• Vaccination can reduce hospitalizations, mortality, and healthcare expenditures in diabetic populations.