Study on dengue severity in diabetic and non-diabetic population of tertiary care hospital by assessing inflammatory indicators

Singh, Ravinder Pal; Goyal, Sanjay; Aggarwal, Namita; Mehta, Sanjana; Kumari, Pratima; Singh, Varinder; Chopra, Hitesh; Emran, Talha Bin

doi:10.1016/j.amsu.2022.104710

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…Second, the study confirms the importance of non-severe bleeding disorders in the DPs as a predictor of SD, which is consistent with studies identifying diabetes as a risk factor for dengue haemorrhagic fever (WHO 1997 classification) [12] or a risk factor for SD (WHO 2009 classification) [37]. Surprisingly, we did not find lower admission platelet counts in DPs than in NDPs, which differs from the recent observation by Singh et al in India [35] and another one in Taiwan. However, on Reunion island, DPs exhibited lower platelet nadir than NDPs upon hospitalization, which may relate the discrepancy between studies to the earlier presentation in the course of illness of DPs (75% within 3 days post-symptom onset).…”

Section: Discussionsupporting

confidence: 92%

“…Among the mechanisms raised to promote the aggravation of dengue in the DP, apoptosis of leucocytes and endothelial microvascular cells has been proposed from post-mortem findings [33], while more recently, a mouse model unravelled the role of hyperglycaemic stress to facilitate DENV replication through the poly(A)-binding protein PI3K/AKT signalling [34]. Together with the microvascular and macrovascular damages of diabetes complications, this would increase the susceptibility of the DPs to the severe plasma leakage key to SD pathogenesis [35]. In our study, the lack of correlates within the subgroups of complicated diabetes and DPs with known HbA1c levels deters to propose a putative mechanism.…”

Section: Discussionmentioning

confidence: 99%

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Dengue clinical features and predictors of severity in the diabetic patient: a retrospective cohort study on Reunion island, 2019

Issop

Bertolotti

Diarra

et al. 2023

Preprint

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AimDiabetes mellitus is associated with both the risks of severe dengue and dengue-related deaths, however the factors characterizing dengue in the diabetic patient are ill-recognized. The objective of this hospital-based cohort study was to identify the factors characterizing dengue and those able to predict dengue severity in the diabetic patient.MethodsWe retrospectively analysed demographic, clinical and biological parameters at admission in the cohort of patients who consulted at the university hospital between January and June 2019 with confirmed dengue. Bivariate and multivariate analyses were conducted.ResultsOf 936 patients, 184 patients (20%) were diabetic. One hundred and eighty-eight patients (20%) developed severe dengue according to the WHO 2009 definition. Diabetic patients were older and had more comorbidities than non-diabetics. In an age-adjusted logistic regression model, loss of appetite, altered mental status, high neutrophil to platelet ratios (>14.7), low haematocrit (≤ 38%), upper-range serum creatinine (>100 μmol/l) and high urea to creatinine ratio (>50) were indicative of dengue in the diabetic patients. In a modified Poisson regression model, four key independent variables were predictive of severe dengue in the diabetic patient: presence of diabetes complications, non-severe bleeding, altered mental status and cough. Among diabetes complications, diabetic retinopathy, and neuropathy but not diabetic nephropathy nor diabetic foot were predictive of severe dengue.ConclusionAt hospital first presentation, dengue in the diabetic patient is characterized by deteriorations in appetite, mental and renal functioning, while severe dengue can be predicted by presence of diabetes complication, dengue-related non-severe haemorrhages, cough, and dengue-related encephalopathy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Dengue clinical features and predictors of severity in the diabetic patient: a retrospective cohort study on Reunion island, 2019

Issop

Bertolotti

Diarra

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The co-occurrence of diabetes and dengue in endemic areas is particularly concerning, as diabetes can worsen dengue complications. diabetics tend to have weaker immune systems, fragile blood vessels, and a higher risk of bleeding [33,34]. However, this study offers some good news for people with diabetes, as Ae.…”

Section: Discussionmentioning

confidence: 87%

Aedes aegypti mosquitoes (Diptera: Culicidae) can discriminate by blood sugar: new insights into comorbidity of dengue and diabetes

bursalı

2024

Preprint

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Purpose Aedes aegypti (L.,1762) is a primary vector of arboviral infections like dengue, yellow fever, Zika. Female mosquitoes are influenced by various physical and chemical cues from host when blood feeding, e.g., they find some individuals with certain blood types or certain conditions more attractive than others. This study determined whether Ae. aegypti shows a preference when offered blood from a patient with diabetes mellitus (DM), an endocrine disorder associated with abnormal glucose metabolism, compared to healthy blood from non-DMs Methods In the dual feeding experiments, forty newly emerged female mosquitoes were provided with two blood feeding systems with blood from a non-diabetic (healthy) and diabetic patient using artificial feeders. Blood from 12 diabetic and 12 non-diabetic patients was matched by ABO blood type (e.g., diabetic type O blood was compared with non-diabetic type O blood). The number of mosquitoes that landed and fed from each membrane was counted every 2 minutes for thirty minutes. Results Ae. aegypti species significantly preferred for blood from non-diabetic individuals (50-65% among the different blood type groups) compared to blood from diabetic individuals. Using multiplex allele-specific PCR it was also determined that, Ae. aegypti significantly preferred the O blood group regardless of blood sugar level compared to others. Conclusion Ae. aegypti has less preference for diabetic blood to non-diabetics. Regardless people affected with this condition need to take preventive measures to reduce mosquito bites as they tend to have weaker immune systems and can experience more severe cases of dengue.

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“…The severity of dengue in diabetic patients has been correlated with many factors including vascular inflammation, oxidative stress, high levels of advanced glycation end products (AGEs), hyperglycemia, poor glycemic control, coexisting comorbidities, high C‐ reactive protein (CRP), IL‐8 levels and greater perfusion index 144,145 All these conditions ultimately contribute to inflammation, favor viral pathogenesis, and worsen dengue complications. Dengue mainly targets the host myeloid cells including monocyte, macrophage and DCs 146 by cell‐specific receptors like dendritic‐cell–specific ICAM3‐grabbing non‐integrin (DC‐SIGN), liver or lymph‐node‐specific ICAM3‐grabbing integrin (L‐SIGN), glycosaminoglycans (CD14), C‐type lectins and mannose receptors (CD206).…”

Section: The Severity Of Flaviviral Infections In Diabetesmentioning

confidence: 99%

Viral infection and host immune response in diabetes

Joshi,

Das,

Verma

et al. 2023

IUBMB Life

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Diabetes, a chronic metabolic disorder disrupting blood sugar regulation, has emerged as a prominent silent pandemic. Uncontrolled diabetes predisposes an individual to develop fatal complications like cardiovascular disorders, kidney damage, and neuropathies and aggravates the severity of treatable infections. Escalating cases of Type 1 and Type 2 diabetes correlate with a global upswing in diabetes‐linked mortality. As a growing global concern with limited preventive interventions, diabetes necessitates extensive research to mitigate its healthcare burden and assist ailing patients. An altered immune system exacerbated by chronic hyperinflammation heightens the susceptibility of diabetic individuals to microbial infections, including notable viruses like SARS‐CoV‐2, dengue, and influenza. Given such a scenario, we scrutinized the literature and compiled molecular pathways and signaling cascades related to immune compartments in diabetics that escalate the severity associated with the above‐mentioned viral infections in them as compared to healthy individuals. The pathogenesis of these viral infections that trigger diabetes compromises both innate and adaptive immune functions and pre‐existing diabetes also leads to heightened disease severity. Lastly, this review succinctly outlines available treatments for diabetics, which may hold promise as preventive or supportive measures to effectively combat these viral infections in the former.

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Study on dengue severity in diabetic and non-diabetic population of tertiary care hospital by assessing inflammatory indicators

Cited by 10 publications

References 15 publications

Dengue clinical features and predictors of severity in the diabetic patient: a retrospective cohort study on Reunion island, 2019

Dengue clinical features and predictors of severity in the diabetic patient: a retrospective cohort study on Reunion island, 2019

Aedes aegypti mosquitoes (Diptera: Culicidae) can discriminate by blood sugar: new insights into comorbidity of dengue and diabetes

Viral infection and host immune response in diabetes

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