Infectious diseases associated with pediatric type 1 diabetes mellitus: A narrative review

Abstract

Diabetes mellitus (DM) has been frequently associated with an impaired immune response against infectious agents, making affected patients at risk for more severe disease and sometimes causing worse outcomes. The recent COVID-19 pandemic has seriously affected patients with both diabetes, in particular those carrying comorbidities or with poor glycemic control. As regards pediatric diabetes mellitus, the availability of more accurate and technological tools for glycemic management and the improved markers of metabolic control might mitigate the negative impact of infections. Notably, good metabolic control of diabetes since its diagnosis reduces not only the risk of microangiopathic complications but also of impaired immune response to infectious diseases. Therefore, vaccinations are strongly recommended. Our paper aims to provide the most updated evidence regarding infectious diseases in type 1 pediatric DM.

Diabetes Insipidus Complicating Diabetes Mellitus Type 1: A Pituitary Abscess Diagnosis

“…One of the largest studies to date on infections in T1DM used the Australian diabetes register and showed elevated mortality from septicemia and osteomyelitis among individuals with T1DM [ 8 ]. DM is frequently associated with an impaired immune response against infectious agents due to microangiopathy and direct impairment of the function of immune system cells, putting affected patients at risk for more severe infectious disease courses, especially those with poorer glycemic control or carrying comorbidities [ 9 ].…”

Endocrinological Involvement in Children and Adolescents Affected by COVID-19: A Narrative Review

“…To summarize, although the literature is discordant, the evidence of a potential role of SARS-CoV-2 in T1D onset and DKA frequency in newly diagnosed and known T1D diabetes is quite consistent, which deserves further investigation to understand the underlying responsible mechanisms. It is well known that some viral infections, especially rubella, Coxsackie, mumps, enterovirus, and the Epstein–Barr virus, represent important environmental risk factors for the development of T1D [ 171 , 172 ]. Since the start of the SARS-CoV-2 pandemic, attention has been paid on this novel virus as a further infective cause in the development and progression of T1D [ 173 ].…”

A pediatric case of an intravesical fungus ball after diabetic ketoacidosis

“…Hyperglycemia and insulin deficiency reduce key mediators of innate humoral and cell‐mediated immune responses to various pathogens, including fungi, and decrease synthesis of inflammatory cytokines 2 . Hyperglycemia increases nutrients for Candida and activity of acid protease, an enzyme that promotes fungal adhesion to epithelial cells, increasing the likelihood of Candida colony formation 3 .…”