Pneumonia May Be More Life-Threatening for People With Diabetes
The influence of pre-existing diabetes mellitus on the host immune response and outcome of pneumonia: analysis of two multicentre cohort studies, by Sachin Yende and colleagues. Thorax 65:870–877, 2010
What is the problem and what is known about it so far?
For a variety of reasons, people with diabetes are thought to be at higher risk for getting infections. However, less is known about whether diabetes affects a person’s chance of dying after they have gotten an infection. Some studies have suggested that people with diabetes are more likely to die after an infection, whereas others have shown no link between diabetes and death after an infection. It could be that a person’s chance of dying is influenced by whether the person had chronic health problems such as kidney disease or heart and blood vessel disease before they got an infection. More study is needed to shed light on this issue.
Why did the researchers do this particular study?
The researchers wanted to find out more about how having diabetes may affect a person’s chance of dying if they have one serious type of infection—pneumonia.
Who was studied?
The study included data from participants in two previous large studies—the GenIMS pneumonia study and the Health ABC study of aging and health.
How was the study done?
The researchers looked at data from the two earlier studies for participants who had diabetes and pneumonia. They looked at tests showing how the participants’ bodies responded to the infection and measuring the function of their kidneys and other organs. They also looked at how many participants died within one year of having pneumonia. They analyzed this data to find possible links among diabetes, the body’s responses to pneumonia, and the chance of dying after having pneumonia.
What did the researchers find?
People who had diabetes were more likely to die within one year of getting pneumonia. However, this was not because of differences in the way their bodies responded to the infection. Instead, it may have been because the pneumonia caused a worsening of other underlying conditions, such as kidney disease and heart and blood vessel disease.
What were the limitations of the study?
The researchers only had information about participants’ blood glucose levels at the time they were admitted to the hospital for pneumonia. Having more information about their glucose levels at different times might have helped explain their higher death rate. In addition, the two studies from which this study got data used different ways of diagnosing diabetes. It is possible that some people who had diabetes were misclassified as not having diabetes and excluded from this study. Finally, the researchers could not tell whether the results they found were influenced by differences in the types of bacteria that can cause pneumonia.
What are the implications of the study?
People with diabetes are more likely than those without diabetes to die within one year of getting pneumonia. Although more study is needed, this seems to be caused not by differences in the way their bodies respond to the infection, but instead because of worsening of underlying problems such as kidney disease and heart and blood vessel disease.
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