Diabetes and Sepsis: Preclinical Findings and Clinical Relevance

• Published in: Diabetes care Vol. 34; no. 3; pp. 771 - 778
• Main Authors: Schuetz, Philipp, Castro, Pedro, Shapiro, Nathan I
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.03.2011
• Subjects: Adaptive Immunity - physiology; Biological and medical sciences; Causes of; Cytokines - metabolism; Diabetes; Diabetes Mellitus - metabolism; Diabetes Mellitus - physiopathology; Diabetes. Impaired glucose tolerance; Diagnosis; Drug therapy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Health aspects; Humans; Hyperglycemia - metabolism; Hyperglycemia - physiopathology; Immune system; Immunity, Innate - physiology; Medical research; Medical sciences; Metabolic diseases; Microorganisms; Miscellaneous; Mortality; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reviews/Commentaries/ADA Statements; Risk factors; Rodents; Sepsis; Sepsis - etiology; Sepsis - immunology; Sepsis - metabolism; Studies; Spain; Endocrinopathy; Infection; Human; Relevance; Sepsis syndrome; Nutrition; Diabetes mellitus; Bacteriosis; Metabolic diseases; Bacteremia; Endocrinology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc10-1185

Because of its high prevalence and potential to alter critical elements of sepsis pathophysiology, diabetes is likely an important comorbid condition in this disease; yet the exact influence of diabetes on infection and the development of sepsis remain undefined. [...] insulin may prevent secondary adverse effects of high blood glucose on the immune function by correcting hyperglycemia as outlined above.\n Therefore, there is no definite answer of whether intensive glucose control has a long-term beneficial effect on the survival of septic patients, and the effect of insulin therapy in sepsis is not clearly delineated. [...] patients with diabetes may have a lower threshold for hospital admission, which could lead to a selection bias when reporting susceptibility rates and expected risks and outcomes.