Diabetic patients suffering dengue are at risk for development of dengue shock syndrome/severe dengue: Emphasizing the impacts of co-existing comorbidity(ies) and glycemic control on dengue severity.
Comorbidities
Dengue shock syndrome
Diabetes mellitus
Glycemic control
Severe dengue
Journal
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi
ISSN: 1995-9133
Titre abrégé: J Microbiol Immunol Infect
Pays: England
ID NLM: 100956211
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
06
06
2016
revised:
18
12
2017
accepted:
29
12
2017
pubmed:
28
8
2018
medline:
21
10
2020
entrez:
28
8
2018
Statut:
ppublish
Résumé
The impact of type 2 diabetes mellitus (DM2) on clinical severity of dengue has not been fully understood. We aimed to assess risk factors for dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) and severe dengue (SD) (defined based on the World Health Organization 1997 and 2009 dengue classifications), and additionally identify, among DM2 patients, who are at risk for developing DHF/DSS and severe dengue. A retrospective analysis of dengue patients diagnosed between 2002 and 2010. Risk factors for development of DHF/DSS/SD were identified using multivariate analysis. To elucidate the impacts of coexisting comorbidity(ies) (i.e., hypertension, chronic kidney disease, old stroke, and/or ischemic heart disease) and glycemic control on clinical outcomes of dengue in DM2 patients, the overall DM2 patients and stratified DM2 patients (HbA1c < 7% vs. HbA1c ≧ 7%), with or without comorbidity(ies), were separately compared to controls (patients without any morbidity). Of 767 (146 DM2 and 621 controls) included patients, 1.4% suffered DSS and 3.3% SD. While DM2 was an independent risk factor for DSS (adjusted odds ratio [AOR] = 7.473; 95% confidence interval [CI] = 2.221-25.146) and SD (AOR = 6.207; 95% CI = 2.464-15.636), only DM2 patients with additional comorbidity(ies) and suboptimal glycemic control (HbA1c ≧ 7%) had significantly higher incidences of non-shock DHF (60.8% vs. 29%), DSS (8.7% vs. 0.8%) and SD (34.8% vs. 1.1%). These data could help narrow down the number of targets in the triage for risky DM2 dengue patients to those with suboptimal glycemic control and co-existing comorbidity(ies).
Sections du résumé
BACKGROUND/PURPOSE
OBJECTIVE
The impact of type 2 diabetes mellitus (DM2) on clinical severity of dengue has not been fully understood. We aimed to assess risk factors for dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS) and severe dengue (SD) (defined based on the World Health Organization 1997 and 2009 dengue classifications), and additionally identify, among DM2 patients, who are at risk for developing DHF/DSS and severe dengue.
METHODS
METHODS
A retrospective analysis of dengue patients diagnosed between 2002 and 2010. Risk factors for development of DHF/DSS/SD were identified using multivariate analysis. To elucidate the impacts of coexisting comorbidity(ies) (i.e., hypertension, chronic kidney disease, old stroke, and/or ischemic heart disease) and glycemic control on clinical outcomes of dengue in DM2 patients, the overall DM2 patients and stratified DM2 patients (HbA1c < 7% vs. HbA1c ≧ 7%), with or without comorbidity(ies), were separately compared to controls (patients without any morbidity).
RESULTS
RESULTS
Of 767 (146 DM2 and 621 controls) included patients, 1.4% suffered DSS and 3.3% SD. While DM2 was an independent risk factor for DSS (adjusted odds ratio [AOR] = 7.473; 95% confidence interval [CI] = 2.221-25.146) and SD (AOR = 6.207; 95% CI = 2.464-15.636), only DM2 patients with additional comorbidity(ies) and suboptimal glycemic control (HbA1c ≧ 7%) had significantly higher incidences of non-shock DHF (60.8% vs. 29%), DSS (8.7% vs. 0.8%) and SD (34.8% vs. 1.1%).
CONCLUSIONS
CONCLUSIONS
These data could help narrow down the number of targets in the triage for risky DM2 dengue patients to those with suboptimal glycemic control and co-existing comorbidity(ies).
Identifiants
pubmed: 30146413
pii: S1684-1182(18)30006-9
doi: 10.1016/j.jmii.2017.12.005
pii:
doi:
Substances chimiques
Blood Glucose
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
69-78Informations de copyright
Copyright © 2018. Published by Elsevier B.V.