Neutrophil dysfunction in diabetes mellitus.

The neutrophil bactericidal capacity of 31 patients with diabetes mellitus in a nonketoacidotic state, including 21 without infections and 10 with recurrent infections, were evaluated. The killed intracellular bacteria (KICB) expressed as the percentage of the initial inoculum for 25 normal control subjects was 95.4 (SD equal plus and minus (2.7) and that for the diabetic patients, the KICB was 72.8 (SD=+30.7)with a p value of less than or equal to 0.01. In 17 out of 31 diabetic atients, the KICB was greater than minus two standard deviations of the control mean. Using the lysostaphin assay technic, 11 patients were shown to phagocytize poorly, 3 had impaired intracellular killing and 3 had a combined defect. These defects were not correctable by normal serum nor related to blood-glucose levels. No apparent correlation with infection could be demonstrated. Fiver of the 10 patients with recurrent infections and 12 out ot of 21 patients without infections has a neutrophil dysfunction. However, all 3 patients with a combined defect had severe bacterial infections.