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Infections in children with diabetes
Luis Eduardo Calliari1, Flávia J Almeida2, Renata Maria Noronha3
1Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Pediatria, Unidade de Endocrinologia Pediátrica e Ambulatório de Diabetes Pediátrico, São Paulo, SP, Brasil.
Insights
Children and adolescents with diabetes mellitus face increased infection risks, impacting blood glucose control. Prompt identification, treatment, and adjusted insulin therapy are crucial for managing infections and preventing complications like diabetic ketoacidosis.
Area of Science:
- Pediatric Endocrinology
- Infectious Diseases
- Metabolic Disorders
Background:
- Diabetes mellitus (DM) is frequently associated with infections, which can disrupt glycemic control even when mild.
- Diabetic patients, particularly those with poor glycemic management, are susceptible to more frequent and severe infections.
- Underlying immune system alterations in pediatric diabetes contribute to increased infection susceptibility and severity.
Purpose of the Study:
- To review common infections in children and adolescents with DM.
- To provide guidance on managing blood glucose levels during infectious episodes in this population.
- To highlight the bidirectional relationship between diabetes and infections.
Main Methods:
- A non-systematic review of PubMed literature.
- Search terms included "diabetes mellitus," "infection," "children," and "adolescents."
- Selection of the most relevant publications.
Main Results:
- Infections can exacerbate hyperglycemia in diabetic individuals, often necessitating increased insulin doses.
- Diabetic pediatric patients exhibit immune dysfunctions that heighten infection risk and severity.
- Infections pose a risk of decompensation and diabetic ketoacidosis (DKA) in children with DM.
Conclusions:
- Prompt identification and treatment of infections are vital for pediatric diabetes patients with immune disorders and hyperglycemia.
- Healthcare providers must intensify glucose monitoring and insulin therapy during infections to prevent DKA.
- Vaccination is a key preventive strategy against many infections in children with diabetes.
Objective:
The association between diabetes mellitus and infections is very common. These infections, even when mild, interfere with blood glucose control. The aim of this review is to describe infections that occur in children and adolescents with DM, as well as to provide recommendations on glycemia management during these episodes.
Source Of Data:
A non-systematic review was carried out in the PubMed database, using the terms "diabetes mellitus," "infection," "children," and "adolescents." The most relevant publications were selected.
Synthesis Of Data:
In addition to the usual community diseases, some infections may occur predominantly in diabetic patients, especially when there is inadequate glycemic control, and common infections can be more severe in these patients. Alterations caused by the disease itself and the immune response are responsible for the risk of higher frequency and severity of infections. During infections, an increase in blood glucose occurs and usually an increase in insulin dose is required.
Conclusions:
Pediatric patients with diabetes have some immune system disorders that, when associated with high glycemia, increase the risk of infections and their severity, and should be promptly identified and treated. The presence of an infectious condition, in turn, raises blood glucose and increases the risk of decompensation, and pediatricians should be cautioned to intensify monitoring and insulin therapy, and to avoid the risk of DKA. It should also be noted that many infections are preventable and can be avoided with adequate vaccine coverage.
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