Comparison of course of infections and antibiotherapy in patients with and without diabetes mellitus – one center experience
More details
Hide details
Students’ Scientific Club at the Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
Corresponding author
Maria Stec   

Students’ Scientific Club at the Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland, Medyków 14, 40-572 Katowice
Ann. Acad. Med. Siles. 2023;77:217-225
Infections affect all patients, including those with diabetes mellitus (DM), which can determine the course of infection. The aim of the study was to compare the course and treatment of infection in patients with DM and without DM.

180 medical records of patients hospitalized in 2021 at the Department of Internal Medicine, Autoimmune and Metabolic Diseases in Katowice, with infections were analyzed. The analysis included age, sex, clinical diagnosis, DM treatment, antibiotic therapy, and laboratory parameters. The Statistica program was used for statistical analysis.

The most prevalent reasons for hospitalization in both groups were: pneumonia in the course of COVID-19 (35.5% DM vs 33.7% non-DM) and urinary tract infections (26.3% DM vs 19.2% non-DM). Significantly more non-DM patients required polyantibiotic treatment (69.7% DM vs 89.4% non-DM). The most frequently used antibiotics were β-lactams (59.2% DM vs 57.7% non-DM). In-hospital mortality was 20% (21% DM vs 19.2% non-DM). The length of hospitalization was 1–35 days, the median in the whole group was 9 days (10 days DM vs 8 days non-DM). Both the initial and terminal CRP concentrations were analyzed. The median of the initial value was 71.6 (72.3 DM vs 66.2 non-DM) and the median of the terminal value was 17.15 (17.9 DM vs 15.3 non-DM). The glucose concentration on admission was assessed with the median 123.5 mg/dL (156 mg/dL DM vs 107 mg/dL non-DM).

Many DM complications are well known, yet the course and treatment of infection do not differ significantly in patients with DM and without DM. Despite that, each patient should be considered individually, so the chosen treatment constitutes an optimized therapy.

Baena-Díez J.M., Peñafiel J., Subirana I., Ramos R., Elosua R., Marín-Ibañez A. et al. Risk of cause-specific death in individuals with diabetes: A competing risks analysis. Diabetes Care 2016; 39(11): 1987–1995, doi: 10.2337/dc16-0614.
Cho N.H., Shaw J.E., Karuranga S., Huang Y., da Rocha Fernandes J.D., Ohlrogge A.W. et al. IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res. Clin. Pract. 2018; 138: 271–281, doi: 10.1016/j.diabres.2018.02.023.
Shaw J.E., Sicree R.A., Zimmet P.Z. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res. Clin. Pract. 2010; 87(1): 4–14, doi: 10.1016/j.diabres.2009.10.007.
International Diabetes Federation. IDF Diabetes Atlas, 1st edn. Brussels, Belgium 2000.
International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium 2021.
Topor‐Madry R., Wojtyniak B., Strojek K., Rutkowski D., Bogusławski S., Ignaszewska-Wyrzykowska A. et al. Prevalence of diabetes in Poland: a combined analysis of national databases. Diabet. Med. 2019; 36(10): 1209–1216, doi: 10.1111/dme.13949.
Emerging Risk Factors Collaboration. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 2010; 375(9733): 2215–2222, doi: 10.1016/s0140-6736(10)60484-9.
Abu-Ashour W., Twells L., Valcour J., Randell A., Donnan J., Howse P. et al. The association between diabetes mellitus and incident infections: a systematic review and meta-analysis of observational studies. BMJ Open Diabetes Res. Care 2017; 5(1): e000336, doi: 10.1136/bmjdrc-2016-000336.
Tillin T., Hughes A.D., Mayet J., Whincup P., Sattar N., Forouhi N.G. et al. The relationship between metabolic risk factors and incident cardiovascular disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited) – a prospective population-based study. J. Am. Coll. Cardiol. 2013; 61(17): 1777–1786, doi: 10.1016/j.jacc.2012.12.046.
Casqueiro J., Casqueiro J., Alves C. Infections in patients with diabetes mellitus: a review of pathogenesis. Indian J. Endocrinol. Metab. 2012; 16(Suppl 1): S27–S36, doi: 10.4103/2230-8210.94253.
Peleg A.Y., Weerarathna T., McCarthy J.S., Davis T.M. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab. Res. Rev. 2007; 23(1): 3–13, doi: 10.1002/dmrr.682.
Flyvbjerg A. Diabetic angiopathy, the complement system and the tumor necrosis factor superfamily. Nat. Rev. Endocrinol. 2010; 6(2): 94–101, doi: 10.1038/nrendo.2009.266.
Wang H., Liu M. Complement C4, infections, and autoimmune diseases. Front. Immunol. 2021; 12: 694928, doi: 10.3389/fimmu.2021.694928.
Geerlings S.E., Hoepelman A.I. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol. Med. Microbiol. 1999; 26(3–4): 259–265, doi: 10.1111/j.1574-695x.1999.tb01397.x.
Khazai N.B., Hamdy O. Inpatient diabetes management in the twenty-first century. Endocrinol. Metab. Clin. North Am. 2016; 45(4): 875–894, doi: 10.1016/j.ecl.2016.06.013.
Gupta S., Koirala J., Khardori R., Khardori N. Infections in diabetes mellitus and hyperglycemia. Infect. Dis. Clin. North Am. 2007; 21(3): 617–638, doi: 10.1016/j.idc.2007.07.003.
van Niekerk G., Davis T., Patterton H.G., Engelbrecht A.M. How does inflammation induced hyperglycemia cause mitochondrial dysfunction in immune cells? Bioessays 2019; 41(5): 1800260, doi: 10.1002/bies.201800260.
Atreja A., Kalra S. Infections in diabetes. J. Pak. Med. Assoc. 2015; 65(9): 1028–1030.
Shah B.R., Hux J.E. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 2003; 26(2): 510–513, doi: 10.2337/diacare.26.2.510.
Zoppini G., Fedeli U., Schievano E., Dauriz M., Targher G., Bonora E. et al. Mortality from infectious diseases in diabetes. Nutr. Metab. Cardiovasc. Dis. 2018; 28(5): 444–450, doi: 10.1016/j.numecd.2017.12.007.
Zhu L., She Z.G., Cheng X., Qin J.J., Zhang X.J., Cai J. et al. Association of blood glucose control and outcomes in patients with COVID-19 and pre-existing type 2 diabetes. Cell Metab. 2020; 31(6): 1068–1077.e3, doi: 10.1016/j.cmet.2020.04.021.
Guo T., Shen Q., Ouyang X., Guo W., Li J., He W. et al . Clinical findings in diabetes mellitus patients with COVID-19. J. Diabetes Res. 2021; 2021: 7830136, doi: 10.1155/2021/7830136.
Fünfstück R., Nicolle L.E., Hanefeld M., Naber K.G. Urinary tract infection in patients with diabetes mellitus. Clin. Nephrol. 2012; 77(1): 40–48, doi: 10.5414/cn107216.
Davies K., Lawrence J., Berry C., Davis G., Yu H., Cai B. et al. Risk factors for primary Clostridium difficile infection; results from the observational study of risk factors for Clostridium difficile infection in hospitalized patients with infective diarrhea (ORCHID). Front. Public Health 2020; 8: 293, doi: 10.3389/fpubh.2020.00293.
Meier K., Nordestgaard A.T., Eid A.I., Kongkaewpaisan N., Lee J.M., Kongwibulwut M. et al. Obesity as protective against, rather than a risk factor for, postoperative Clostridium difficile infection: a nationwide retrospective analysis of 1,426,807 surgical patients. J. Trauma Acute Care Surg. 2019; 86(6): 1001–1009, doi: 10.1097/TA.0000000000002249.
Knapp S. Diabetes and infection: is there a link? A mini-review. Gerontology 2013; 59(2): 99–104, doi: 10.1159/000345107.
Journals System - logo
Scroll to top