Relationship between Escherichia coli O157:H7 and diabetes mellitus

Abstract

Ingestion of Escherichia coli O157:H7 can cause a spectrum of acute illness, ranging from overt hemolytic-uremic syndrome (HUS), to gastroenteritis with bloody diarrhea, to no symptoms. This organism has been responsible for dozens of outbreaks of gastroenteritis and HUS in industrialized nations, and thus is a major public health concern. Although the acute effects of E. coli O157:H7 ingestion are well understood, the long-term complications are less well known. Here, we review the biological and empirical evidence supporting a link between E. coli O157:H7 and long-term diabetes mellitus. Survivors with diarrhea-associated HUS have a significantly increased incidence of diabetes due to complete insulin deficiency, which may recur several years after the initial infection. However, less severe forms of infection, such as E. coli O157:H7 gastroenteritis without overt HUS, do not appear to result in an increased risk of type 2 diabetes.

Shiga Toxin-Associated Hemolytic Uremic Syndrome: A Narrative Review

“…Biological pancreatitis, as well as elevated liver enzymes, occur in 20% of STEC-HUS patients [237] but do not commonly result in organ failure. Nevertheless, around 3% of patients have hyperglycemia during the acute phase [257], and survivors of STEC-HUS (but not uncomplicated EHEC infection) have a significantly increased incidence of diabetes [258], possibly as a consequence of thrombosis of vessels supplying the islets of Langerhans as evidenced in autopsy series. Diabetes may be transient, yet the partial reduction in the stock of Langerhans islets may translate to the re-emergence of diabetes after a variable delay [252,258,259].…”

Outbreak of Escherichia coli and diabetes mellitus

“…The infection started in Germany and spread widely in Europe. [1] The pathogenic E. coli infection can cause severe diarrhea as well as other more serious presentations. In some severe cases, infected with E. coli , O157: H7, renal complications such as hemolytic uremic (HUS) syndrome can be expected.…”

“…Due to pancreatic injury,[2] the increased incidence of insulin-dependent diabetes mellitus in pediatric patients infected with O157: H7 E. coli is reported. [13] It usually accompanies renal failure, which is a complication of HUS. [1–5] Suri et al .…”

“…[13] It usually accompanies renal failure, which is a complication of HUS. [1–5] Suri et al . mentioned that “Survivors with diarrhea-associated HUS have a significantly increased incidence of diabetes due to complete insulin deficiency, which may recur several years after the initial infection.”[1] As a conclusion, Suri et al .…”

“…[1–5] Suri et al . mentioned that “Survivors with diarrhea-associated HUS have a significantly increased incidence of diabetes due to complete insulin deficiency, which may recur several years after the initial infection.”[1] As a conclusion, Suri et al . proposed following up for diabetes among the affected patients during acute illness and in long term after severe infection.…”