Endocrine Abstracts

Introduction: Type 2 diabetes is an important risk factor for all forms of infection. It may be unrecognised for many years, and often revealed by degenerative or infectious complications. The aim of this study is to investigate the epidemiological, clinical and therapeutic aspects of severe infections revealing type 2 diabetes.

Patients and Methods: Retrospective descriptive cross-sectional study of a series of 5 patients with severe infections revealing type 2 diabetes.

Outcomes: The mean age of our patients was 44.8 years [33-49 years], with a 60% female predominance (3/5). The mean hemoglobin A1c at the time of diagnosis was 11.1% [8-14.3%]. Infections were: Kidney abscess, breast abscess, diabetic foot with phlegmon, pyo-pneumothorax, severe pneumonia. Ketoacidosis or ketosis decompensation was associated in 60% (3/5) of cases. The therapeutic management differed according to the type of infection. All patients had broad-spectrum intravenous antibiotic therapy and received insulin therapy. Discussion: Type 2 diabetes can remain silent for many years, often revealed by degenerative or infectious complications. It is an immunocompromising condition that predisposes to infections in all its sites. This appears to be related to deficits in the immune system, particularly changes in innate immunity. Respiratory infections, cutaneous and soft tissue infections, gastrointestinal and genitourinary infections all appear to occur more frequently in people with diabetes. Not only are they more frequent, but these infections seem to have a poorer response to treatment and a more rapid progression to severe forms of infection.

Conclusion: Infections revealing type 2 diabetes are common, and routine screening for diabetes in patients with severe or recurrent infections is necessary.