OBJECTIVES: We sought to determine whether poor glucose control among diabetics is associated with increased risk for pneumococcal pneumonia and whether elevated admitting plasma glucose (APG) levels are associated with increased severity of this infection in diabetic and non-diabetic patients. METHODS: We compared hemoglobin A(1c) (HbA(1c)) in diabetics who had pneumococcal pneumonia with diabetic case-controls who did not have pneumonia. In patients with pneumococcal pneumonia, we related APG to disease severity as determined by SMART-COP score, need for ICU admission, and mortality at 7 and 30 days. RESULTS: Fifty-three of 233 patients with pneumococcal pneumonia (22.7%) were diabetic. Diabetics with pneumonia had poorer glycemic control than diabetic case-controls (HbA(1c) 8.2% vs. 7.2%, respectively, P<0.01). In pneumococcal pneumonia patients, SMART-COP scores, need for ICU admission, and mortality increased in proportion to the APG. These findings were attributable to the significant association between hyperglycemia and severity in non-diabetics. CONCLUSIONS: Poor glycemic control predisposes diabetics to pneumococcal pneumonia but, among diabetics, the degree of hyperglycemia at admission is not associated with increased disease severity. In contrast, among non-diabetics with pneumococcal pneumonia, hyperglycemia is a marker for severe disease and increased mortality, perhaps reflecting massive release of cytokines and glucocorticosteroids in overwhelming infection. Copyright 2009 The British Infection Society. All rights reserved.
OBJECTIVES: We sought to determine whether poor glucose control among diabetics is associated with increased risk for pneumococcal pneumonia and whether elevated admitting plasma glucose (APG) levels are associated with increased severity of this infection in diabetic and non-diabeticpatients. METHODS: We compared hemoglobin A(1c) (HbA(1c)) in diabetics who had pneumococcal pneumonia with diabetic case-controls who did not have pneumonia. In patients with pneumococcal pneumonia, we related APG to disease severity as determined by SMART-COP score, need for ICU admission, and mortality at 7 and 30 days. RESULTS: Fifty-three of 233 patients with pneumococcal pneumonia (22.7%) were diabetic. Diabetics with pneumonia had poorer glycemic control than diabetic case-controls (HbA(1c) 8.2% vs. 7.2%, respectively, P<0.01). In pneumococcal pneumoniapatients, SMART-COP scores, need for ICU admission, and mortality increased in proportion to the APG. These findings were attributable to the significant association between hyperglycemia and severity in non-diabetics. CONCLUSIONS: Poor glycemic control predisposes diabetics to pneumococcal pneumonia but, among diabetics, the degree of hyperglycemia at admission is not associated with increased disease severity. In contrast, among non-diabetics with pneumococcal pneumonia, hyperglycemia is a marker for severe disease and increased mortality, perhaps reflecting massive release of cytokines and glucocorticosteroids in overwhelming infection. Copyright 2009 The British Infection Society. All rights reserved.
Authors: Travis J Cyphert; Robert T Morris; Lawrence M House; Tammy M Barnes; Yolanda F Otero; Whitney J Barham; Raphael P Hunt; Rinat Zaynagetdinov; Fiona E Yull; Timothy S Blackwell; Owen P McGuinness Journal: Am J Physiol Regul Integr Comp Physiol Date: 2015-09-16 Impact factor: 3.619
Authors: Rahul D Barmanray; Nathan Cheuk; Spiros Fourlanos; Peter B Greenberg; Peter G Colman; Leon J Worth Journal: BMJ Open Diabetes Res Care Date: 2022-07
Authors: Philipp M Lepper; Sebastian Ott; Eveline Nüesch; Maximilian von Eynatten; Christian Schumann; Mathias W Pletz; Nicole M Mealing; Tobias Welte; Torsten T Bauer; Norbert Suttorp; Peter Jüni; Robert Bals; Gernot Rohde Journal: BMJ Date: 2012-05-28