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| REVIEW ARTICLE |
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| Year : 2012 | Volume
: 16
| Issue : 7 | Page : 27-36 |
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Infections in patients with diabetes mellitus: A review of pathogenesis
Juliana Casqueiro, Janine Casqueiro, Cresio Alves
Department of Pediatrics, Pediatric Endocrinology Unit, Hospital Universitario Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| Date of Web Publication | 24-Mar-2012 |
Correspondence Address:
Cresio Alves
Department of Pediatrics, Pediatric Endocrinology Unit, Hospital Universitário Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Rua Plínio Moscoso, 222/601, CEP: 40157-190, Salvador - Bahia
Brazil
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2230-8210.94253
 Abstract | | |
In general, infectious diseases are more frequent and/or serious in patients with diabetes mellitus, which potentially increases their morbimortality. The greater frequency of infections in diabetic patients is caused by the hyperglycemic environment that favors immune dysfunction (e.g., damage to the neutrophil function, depression of the antioxidant system, and humoral immunity), micro- and macro-angiopathies, neuropathy, decrease in the antibacterial activity of urine, gastrointestinal and urinary dysmotility, and greater number of medical interventions in these patients. The infections affect all organs and systems. Some of these problems are seen mostly in diabetic people, such as foot infections, malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis. In addition to the increased morbidity, infectious processes may be the first manifestation of diabetes mellitus or the precipitating factors for complications inherent to the disease, such as diabetic ketoacidosis and hypoglycemia. Immunization with anti-pneumococcal and influenza vaccines is recommended to reduce hospitalizations, deaths, and medical expenses. Keywords: Diabetes mellitus, immunization, infections, vaccines
How to cite this article:
Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocr Metab 2012;16, Suppl S1:27-36 |
How to cite this URL:
Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: A review of pathogenesis. Indian J Endocr Metab [serial online] 2012 [cited 2020 Sep 25];16, Suppl S1:27-36. Available from: http://www.ijem.in/text.asp?2012/16/7/27/94253 |
| Introduction | |  |
Diabetes mellitus (DM) is a clinical syndrome associated with deficiency of insulin secretion or action. It is considered one of the largest emerging threats to health in the 21 st century. It is estimated that there will be 380 million persons with DM in 2025. [1] Besides the classical complications of the disease, DM has been associated with reduced response of T cells, neutrophil function, and disorders of humoral immunity. [2],[3],[4] Consequently, DM increases the susceptibility to infections, both the most common ones as well as those that almost always affect only people with DM (e.g. rhinocerebral mucormycosis). [4] Such infections, in addition to the repercussions associated with its infectivity, may trigger DM complications such as hypoglycemia and ketoacidosis.
This article aims to critically review the current knowledge on the mechanisms associated with the greater susceptibility of DM for developing infectious diseases and to describe the main infectious diseases associated with this metabolic disorder.
| Materials and Methods | | |
The MEDLINE and LILACS databases were searched for articles published between 1999 and 2011, using the following keywords in various combinations: "diabetes mellitus," "infections," "immunization," and "vaccines." Bibliographic search included consensus papers, editorials, original articles, and review articles written in English, Spanish, and Portuguese. The articles were initially selected on the basis of their titles and abstracts. Articles published in languages other than the selected ones, articles without abstract, and those articles whose titles were not relevant to the purpose of this review were excluded.
| Diabetes Mellitus and Infections: Physiopathology | | |
The main mechanisms associated with the interface DM and infections are depicted in [Figure 1]. | Figure 1: Pathophysiology of infections associated with diabetes millitus
Click here to view |
Complement
The complement system is one of the main mechanisms responsible for the humoral immunity. It consists of serum and surface proteins whose main functions are to promote the opsonization and phagocytosis of microorganisms through macrophages and neutrophils and to induce the lysis of these microorganisms. Moreover, complement activation products provide the second signal for B-lymphocyte activation and antibody production.
Although some studies have detected a deficiency of the C4 component in DM, [5],[6] this reduction of C4 is probably associated with polymorphonuclear dysfunction and reduced cytokine response. [2],[5]
Inflammatory cytokines
Mononuclear cells and monocytes of persons with DM secrete less interleukin-1 (IL-1) and IL-6 in response to stimulation by lipopolysaccharides. [2],[4] It appears that the low production of interleukins is a consequence of an intrinsic defect in the cells of individuals with DM. [2],[7] However, other studies reported that the increased glycation could inhibit the production of IL-10 by myeloid cells, as well as that of interferon gamma (IFN-γ) and tumor necrosis factor (TNF)-α by T cells. Glycation would also reduce the expression of class I major histocompatibility complex (MHC) on the surface of myeloid cells, impairing cell immunity. [8]
Polymorphonuclear and mononuclear leukocytes
Decreased mobilization of polymorphonuclear leukocytes, chemotaxis, and phagocytic activity may occur during hyperglycemia. [4],[9],[10] The hyperglycemic environment also blocks the antimicrobial function by inhibiting glucose-6-phosphate dehydrogenase (G6PD), increasing apoptosis of polymorphonuclear leukocytes, and reducing polymorphonuclear leukocyte transmigration through the endothelium. [4] In tissues that do not need insulin for glucose transport, the hyperglycemic environment increases intracellular glucose levels, which are then metabolized, using NADPH as a cofactor. The decrease in the levels of NADPH prevents the regeneration of molecules that play a key role in antioxidant mechanisms of the cell, thereby increasing the susceptibility to oxidative stress.
Regarding the mononuclear lymphocytes, some studies had demonstrated that when the glycated hemoglobin (HbA1c) is <8.0%, the proliferative function of CD4 T lymphocytes and their response to antigens is not impaired. [4]
Antibodies
Glycation of immunoglobulin occurs in patients with diabetes in proportion with the increase in HbA1c, and this may harm the biological function of the antibodies. [4] However, the clinical relevance of these observations is not clear, since the response of antibodies after vaccination and to common infections is adequate in persons with DM. [4]
| Major Infections Associated with Diabetes Mellitus | | |
Some investigators claim that the differences in the risk factors for infection between diabetic and non-diabetic patients result either from non-controlled studies or biased studies (e.g. persons with DM have frequent medical appointments which may increase the probability of being diagnosed with other diseases). However, most researchers conclude that there is clinical evidence pointing to the higher prevalence of infectious diseases among individuals with DM. [2],[3],[10] [Table 1] summarizes the major infections associated with DM.
Respiratory infections
Respiratory tract infections are responsible for a significant number of medical appointments by persons with DM compared to those without DM. [4],[11],[12],[13],[14],[15],[16]
Streptococcus pneumoniae and influenza virus
The most frequent respiratory infections associated with DM are caused by Streptococcus pneumoniae and influenza virus. [9],[15] Persons with DM six times more likely need hospitalization during influenza epidemics than non-diabetic patients. [4] Diabetes is also a common coexisting condition and a risk factor for complications in patients with H1N1 (pandemic influenza virus) infection. [17]
The American Diabetes Association (ADA) [11] and the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) [13] recommend anti-pneumococcal and influenza vaccination for people with DM, as shown in [Table 2] and [Table 3], respectively. The World Health Organization recommends vaccination against the H1N1 virus, which is a single-dose vaccine, to minimize the virus-related morbidity and mortality. [18]  | Table 2: Influenza vaccination in patients with diabetes mellitus[11],[12],[13]
Click here to view |
 | Table 3: Pneumococcal vaccination in patients with diabetes mellitus[11],[12],[13]
Click here to view |
These vaccines reduce the number of respiratory infections, the number and length of hospitalizations, the deaths caused by respiratory tract infections, and the medical expenses related to influenza and pneumonia. [15] Despite these benefits, the vaccination coverage in persons with DM remains inadequate. [19],[20]
Tuberculosis
In 2009, approximately 9 million new cases of tuberculosis were diagnosed and 1.7 million persons died from this infection. [21] Patients with diabetes are at higher risk of contracting tuberculosis than individuals without DM. [21,22] Some studies have reported that persons with DM are more likely to develop multi-resistant tuberculosis and that treatment failures and death are more frequent in these patients. [23] In addition, tuberculosis infection and treatment (rifampicin increasing the metabolism of oral antidiabetic drugs) may complicate the glycemic control. [24]
It is suggested that DM depresses the immune response (impairing chemotaxis, phagocytosis, and antigen presentation in response to Mycobacterium tuberculosis infection and affecting T-cell function and proliferation) facilitating infection and progression to symptomatic disease. [21],[22],[23]
The association of these two diseases poses a major burden to the health public system, especially in the developing countries where tuberculosis is one of the most important causes of bacterial infection and the prevalence of type 2 DM is increasing. Therefore, routine screening of patients with tuberculosis for DM and patients with DM for tuberculosis should be implemented.
Urinary infections
Urinary tract infections (UTIs) are more prevalent in individuals with DM and may evolve to complications and/or serious manifestations. [25],[26],[27] The main risk factors for UTI in DM are: inadequate glycemic control, duration of DM, diabetic microangiopathy, impaired leukocyte function, recurrent vaginitis, and anatomical and functional abnormalities of the urinary tract. [4],[25],[26],[27],[28],[29]
Asymptomatic bacteriuria
Although women with DM have greater prevalence of asymptomatic bacteriuria, [25],[27],[28],[29],[30] the data on the natural history of this condition in women with DM are conflicting. Some studies reported progression to pyelonephritis, [28],[30] whereas other suggested that this does not lead to serious complications. [11],[25],[31] Thus, the routine recommendation of antibiotic therapy for asymptomatic bacteriuria in diabetic women remains controversial. [16]
Bacterial pyelonephritis
Acute pyelonephritis is 4-5 times more common in individuals with DM. [26] Most infections are caused by Escherichia More Details coli or Proteus sp. [9] The clinical presentation is similar to that of non-diabetic individuals, except for the bilateral renal involvement. [4],[32] Additionally, persons with DM are at increased risk for complications such as perinephric and/or renal abscesses, emphysematous pyelonephritis (EP), and renal papillary necrosis. [4],[9],[32]
Emphysematous pyelonephritis
EP is characterized by necrosis of the renal parenchyma with the presence of gas in the collecting system or in the perinephric tissues. [30],[31],[32],[33],[34],[35],[36] It is most commonly observed in DM women. [16],[25],[32],[33],[34],[35],[36]
E. coli and Enterobacter aerogenes are the most frequent pathogens, followed by Klebsiella sp., Proteus sp., Candida and Streptococcus sp. [9],[32],[33]
Fever, chills, mass and flank pain, nausea, and vomiting are the first symptoms. [27] Crackles in the flank or thigh are less frequent. [16],[32],[35],[37] Abdominal computerized tomography allows the identification of gas in the urinary tract. [9],[16],[32],[33],[38],[39],[40]
Fungal cystitis
Fungal infections are more common in DM, particularly those caused by Candida.[28],[41] The distinction between infection and colonization can be difficult. The presence of urinary symptoms or pyuria suggests infection. [9] Fungal cystitis may result in the formation of "fungal balls" which may complicate as urinary tract obstruction. [28]
Emphysematous cystitis
Emphysematous cystitis affects persons with DM more frequently than non-diabetics. [26],[40],[42],[43] It is characterized by the presence of gas in the bladder cavity and infiltration of the bladder wall due to infection by bacteria that produce carbon dioxide. [44] The most frequent pathogen is E. coli, followed by Enterobacter, Proteus, Klebsiella, and Candida. [32] Women are more affected than men. [26],[40],[44] Computerized tomography is the standard diagnostic method. [42]
Perinephric abscess
The main etiologies of renal and perinephric abscesses are enteric gram-negative bacilli (predominantly E. coli) or polymicrobial infection. [45],[46],[47] Around one-third of perinephric abscesses occur in persons with DM. [16],[46],[47]
The initial clinical manifestations are fever, backache, dysuria, and/or polyuria. [47] A palpable mass may be present. [42] In case of perirenal suppuration, the overlying skin may show inflammatory reaction. [48] In individuals with DM, the clinical presentation is non-specific. Therefore, the diagnosis is usually late, contributing to worse prognosis. This diagnosis should be considered in patients with acute pyelonephritis that does not get better after antimicrobial therapy. [45]
Gastrointestinal and liver infections
The regularity of gastrointestinal motility and sensitivity are important mechanisms of defense against infections. [32] Chronic hyperglycemia contributes to increase the risk of gastrointestinal infectious processes. [32],[49]
Gastritis caused by Helicobater pylori
The association of DM and infection by Helicobacter pylori is controversial. Although some studies showed that some virulent strains of H. pylori are related to macroangiopathy, neuropathy, and microalbuminuria in patients with DM2, there is apparently no relationship between H. pylori infection and these DM complications. [49],[50],[51],[52],[53]
Some data indicate a possible association of H. pylori infection with coronary insufficiency and/or cerebral occlusive vascular disease in adults with DM. [51] Another consequence of this infection is the increase in insulin requirements in children with DM1. [51]
The efficiency of H. pylori eradication is lower in persons with DM, whereas the re-infection rates are seen to be higher. [50],[51],[54]
Oral and esophageal candidiasis
The most common etiological agent is Candida albicans. [4],[55] Its pathogenesis is related to a combination of factors that increase its virulence, with emphasis on the production of extracellular enzymes such as proteinase and phospholipase. [55] Candidiasis manifests in different ways: median rhomboid glossitis or central papillary atrophy, atrophic glossitis, denture stomatitis, pseudomembranous candidiasis, and angular cheilitis. [55] The diagnosis is eminently clinical. However, in case of esophageal candidiasis, endoscopy is needed. [55]
Emphysematous cholecystitis
The emphysematous cholecystitis is more frequent in males with DM. [32] The main pathogens are Salmonella More Details enteritidis and Campylobacter.[32] The clinical presentation is not different from that of non-complicated cholecystitis (e.g. right upper quadrant abdominal pain, vomiting, and fever). [9] Clinical signs of peritonitis are usually not observed. Crackles can be felt on abdominal palpation, being associated with a worse prognosis. [9] The diagnosis is made by the detection of gas inside the gall bladder, demonstrated in radiograph or computerized tomography scan. [32]
Hepatitis C
Hepatitis C virus (HCV) is a major public health problem affecting more than 170 million people worldwide and this figure is expected to increase due the lack of a vaccine to prevent it. [56] Approximately 50-80% of these patients develop a chronic infection and have a greater chance to progress to cirrhosis.
Several studies, from different countries, have reported that 13-33% of patients with HCV infection have diabetes, mostly type 2 diabetes mellitus (T2DM), [57] compared with the prevalence of 4-10% for non-HCV control population. [58] These data suggest that patients with HCV are 3 times more likely to develop DM than individuals who are HCV negative. Therefore, T2DM is considered an extrahepatic manifestation of this infection. [57]
Patients with HCV who develop T2DM have a more severe liver disease and increased fibrosis compared to non-diabetic HCV patients. [59] Possible explanations are that in individuals with a genetic predisposition to T2DM, the HCV infection could cause (1) impairment of beta-cell responsiveness as a result of a direct viral effect, mostly the genotype 1 or 4, [60] and/or (2) liver damage leading to an abnormal glucose metabolism and insulin resistance. [57]
Early screening for T2DM should be instituted in all patients with HCV, especially if they have other risk factors for diabetes, and screening for T2DM should be performed in areas of high HCV prevalence.
Hepatitis B
About 350 million people are infected by the hepatitis B virus (HBV) worldwide. [60] This number is expected to decrease with the availability and widespread use of the anti-HBV vaccine.
The studies on the relationship between HBV and T2DM are not consistent. Some investigators have reported blood glucose abnormalities, [61] while others have not. [62] Lao et al. [63] reported an independent association between HBV infection and gestational diabetes. Further studies are needed to clarify this questionable association.
However, HBV infection outbreaks have been reported among diabetic patients who share a blood glucose meter without cleaning and disinfecting between uses, associated with limited awareness of the high risk for HBV transmission during fingerstick blood glucose monitoring. [64]
Enteroviruses
Enteroviruses are largely distributed in the world and are mainly transmitted by the fecal-oral route. They are classified into five species: poliovirus, human enterovirus A, human enterovirus B (including the six Coxsackie B virus serotypes), echovirus C, and echovirus D.
Several epidemiological and clinical studies have supported the role of enterovirus, especially Coxsackie B4 and B3 virus, in the development of T1DM in genetically predisposed individuals. [6] Such association is supported by the description of a temporal relationship between the occurrence of T1DM and peaks of enterovirus infections and by the detection of anti-enterovius antibodies, enterovirus RNA, and capsid protein VP1 in blood, small intestine biopsies, and autopsy pancreas specimens of individuals with T1DM. [65]
Various mechanisms can explain the role of enterovirus in the pathogenesis of T1DM: [65],[66] (1) persistent infection of pancreatic beta cells provoking cell damage and release of sequestered antigens inducing an autoimmune response; (2) molecular mimicry (partial sequence homology) between the 2C viral protease and the GAD65 (Glutamic Acid Descarboxilase) and between the VP1 viral capsid protein and the IA2 protein; (3) bystander activation of autoreactive T cells; (4) thymus infection; and (5) loss of regulatory T cells. However, a causative correlation still needs to be established.
Skin and soft tissue infection
Persons with DM are more predisposed to skin and soft tissue infections such as folliculitis, furunculosis, and subcutaneous abscesses. These infections may break out during the course of the disease or may be the first sign of DM presentation, [67],[68] and can also be more severe in these populations. [4],[32],[67]
Foot infection
Foot infections are the most important chronic complications of DM, being one of the most common causes of hospitalization and often resulting in amputation, osteomyelitis, and death. [4],[9],[67],[69],[70]
The clinical signs of infections are very protean and poor, often leading to delayed diagnosis. [71] The diabetic foot infections are usually divided into moderate or "non-limb threatening" and serious or "limb-threatening." [32],[70],[72] Moderate infections are defined as superficial, with cellulitis less than 2.0 cm in the largest diameter, without evidence of serious ischemia, systemic toxicity, or bone and/or articular involvement. Serious infections are defined as deep ulceration, with celullitis equal to or greater than 2.0 cm in the largest diameter, with evidence of serious ischemia, systemic toxicity, or bone and/or joint involvement. [72]
These infections can be monomicrobial or polymicrobial. Staphylococcus aureus and Staphylococcus epidermidis are isolated from around 60% of all the infected ulcers. Enterococci, streptococci, and enterobacteria are less frequent, and 15% of the infected ulcers have strict anaerobic bacteria. [70]
Infection in a very recently acquired superficial ulcer is likely to be monomicrobial due to aerobic Gram-positive cocci, such as staphylococci, while a long duration of ulceration and increased depth are likely to increase the chances of the wound, yielding both polymicrobial growth and resistant organisms. [70]
Simple clinical assessments are predictive of bone involvement, such as size and depth of ulcer. Ulcers larger or deeper than 2 cm2 are more likely to be associated with underlying bone infection. [16],[32],[71] It is worth stressing that imaging evaluation can be normal in the beginning of the infection, since radiological abnormalities are either observed 10-20 days after the beginning of the infectious process or when 40-70% of the bone is lost. [16],[32] Thus, the most sensitive tests are scintigraphy and magnetic resonance imaging. [16]
Necrotizing fasciitis
Necrotizing fasciitis is characterized by fast and progressive necrosis of the fascia and subcutaneous tissue, causing fulminant local tissue destruction, microvascular thrombosis, and systemic signs of toxicity. Mortality occurs in approximately 40% of the cases. [9],[73],[74],[75],[76]
The initial symptoms are fever and intense local pain, followed by areas of skin necrosis with small ulcers that drain a colorless fluid and have unpleasant smell. [16],[32] Air in the soft tissues can be better detected by radiograph. [32] The most affected sites are thorax, abdominal wall, extremities, perineum, and groin. [74],[75],[76]
In DM, fasciitis is typically polymicrobial, with one anaerobic and many aerobic microorganisms. [16] Type I fasciitis is caused by the combination of an anaerobic microorganism with one or more facultative aerobic microorganisms, and type II fasciitis is caused by a group A streptococcus with or without the involvement of staphylococci. [75],[76]
Fournier gangrene
Fournier gangrene is a fasciitis that affects the male genitalia. The most common etiologic agents are E. coli, Klebsiella sp., Proteus sp., and Peptostreptococcus.[77],[78] The etiology can also be polymicrobial, involving Clostridium, aerobic or anaerobic streptococci, and Bacteroides.[32],[78]
Up to 70% of the patients with this infection have DM. [29],[32],[77] It usually involves the scrotum, but can be extend to the penis, perineum, and abdominal wall. [9],[16],[29],[78] Contrary to the general belief, the testicles are usually spared. [77]
Head and neck infections
The two most serious head and neck infections in diabetic persons are invasive external otitis and rhinocerebral mucormycosis. [32]
Invasive external otitis
Invasive external otitis is an infection of the external auditory canal that can extend to the skull base and adjacent regions. [9],[16],[79] It often affects elderly diabetic individuals and the etiologic agent is usually Pseudomonas aeruginosa.[16],[79]
Excruciating pain, otorrhea, and hearing loss are the characteristics. [9] Skull base osteomyelitis and cranial nerve involvement may occur. Facial paralysis occurs in 50% of the cases. [16] The best diagnostic method is the magnetic resonance imaging. [16]
Rhinocerebral mucormycosis
Mucormycosis is a rare opportunistic and invasive infection caused by fungi of the class Zygomycetes. [80],[81] The genus most commonly associated with human infections is the Rhizopus, followed by Mucor and Cunninghamella.[82]
This infection occurs in approximately 50% of the cases in individuals with DM due to the greater availability of glucose to the pathogen that causes mucormycosis, the decrease in serum inhibitory activity against the Rhizopus in lower pH, and the increased expression of some host receptors that mediate the invasion and damage to human epithelial cells by Rhizopus.[32],[79],[83]
The mucormycosis can be acute and chronic. [80],[81],[82] The classical triad is characterized by paranasal sinusitis, ophthalmoplegia with blindness, and unilateral proptosis with cellulitis. [16],[80] Facial or eye pain and necrotic wound of the palate of the nasal mucosa may occur. Black necrotic eschar in the nasal cornets is a characteristic sign. [16],[85],[82]
Periodontitis
Periodontitis is a chronic inflammatory disease characterized by the formation of a periodontal pocket, loss of connective tissue, and alveolar bone resorption, which may sometimes result in tooth loss. It is four times more common in persons with DM and is considered the sixth most common complication of DM. [4],[84],[85] Periodontitis starts or disseminates insulin resistance, thus worsening glycemic control. [4],[16],[84],[85],[86] Inversely, persistent poor glycemic control has been associated with a greater incidence and progression of gingivitis and periodontitis, producing a vicious circle. [4],[85],[86]
Many mechanisms have been proposed to explain the increased susceptibility to periodontal disease in these patients, such as alterations in immune response, subgingival microbiota aspects, altered collagen metabolism, alteration in oral vascularization, hereditary patterns, altered neutrophil function, reduced phagocytic capacity, and chemotaxis. [4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21],[22],[23],[24],[25],[26],[27],[28],[29],[30],[31],[32],[33],[34],[35],[36],[37],[38],[39],[40],[41],[42],[43],[44],[45],[46],[47],[48],[49],[50],[51],[52],[53],[54],[55],[56],[57],[58],[59],[60],[61],[62],[63],[64],[65],[66],[67],[68],[69],[70],[71],[72],[73],[74],[75],[76],[77],[78],[79],[80],[81],[82],[83],[84]
Other infections
Human immunodeficiency virus
Approximately 33 million people were infected by the human immunodeficiency virus (HIV) in 2007. [87] The improvements in diagnosis and treatment have translated into an increasing number of patients developing chronic complications including DM.
The increased risk of developing diabetes is related to the HIV itself or its treatment. [88] Insulin resistance is the main mechanism implicated in the pathogenesis of diabetes in HIV patients. [87] Insulin resistance results from high levels of inflammatory cytokines that impair glucose tolerance, leading to the development of T2DM. More recently, some patients were reported to develop autoimmune T1DM after immune restoration during highly active antiretroviral therapy (HAART). [89]
Risk factors for DM in HIV patients are: high viral burden, low CD4 count, longer duration of HIV infection, advancing age, male gender, lower socioeconomic class, and accumulation of visceral fat. [87]
Diabetes is fourfold more frequent in HIV patients on HAART. [89] The protease inhibitors cause insulin resistance by interfering with the GLUT-4 mediated transport and by inhibiting the peroxisomal proliferator activated receptor which increases the release of fatty acids and induces insulin resistance. The nucleoside reverse transcriptase inhibitors also contribute to the insulin resistance.
Patients with HIV should be screened for diabetes at diagnosis, at the onset, and during HAART therapy. An oral glucose tolerance test is recommended to assess the insulin resistance. The treatment of DM in HIV poses some limitations. For example, although metformin is the drug of choice, its use may not be tolerated by cachexic patients or by those with lypoatrophy. The side effects of thiazolidinediones (e.g. higher cardiovascular morbidity, osteoporosis) may prevent their use in HIV patients with diabetes. Glinides and sulfonylureas may not be effective due to insulin resistance. [87] Therefore, insulin is the drug of choice for the HIV-associated diabetes.
Other viruses
T1DM has been associated with other viral infections including rubella, mumps, Epstein-Barr and cytomegalovirus. The viral infection usually precedes the clinical presentation of T1DM. The causality between enterovirus infections and the diabetogenic proocess are still unclear. [90]
| Conclusions | | |
Infectious diseases are more prevalent in individuals with DM. The main pathogenic mechanisms are: hyperglycemic environment increasing the virulence of some pathogens; lower production of interleukins in response to infection; reduced chemotaxis and phagocytic activity, immobilization of polymorphonuclear leukocytes; glycosuria, gastrointestinal and urinary dysmotility. Some infections almost always affect only diabetic persons, such as malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis. In addition to being potentially more serious, infectious diseases in DM may result in metabolic complications such as hypoglycemia, ketoacidosis, and coma. The recommendation of compulsory immunization with anti-pneumococcal and influenza vaccines is essential because of their impact on the reduction of respiratory infections, the number and length of hospitalizations and the number of deaths related to respiratory tract diseases.
More research is needed for clarification of the immunopathogenic mechanisms linking DM and infections and to develop strategies to improve vaccination coverage for diabetic patients.
| References | | |
| 1. | Atkins RC, Zimmet P. Diabetic kidney disease: Act now or pay later. Saudi J Kidney Dis Transpl 2010;21:217-21. 
[PUBMED]  |
| 2. | Geerlings SE, Hoepelman AI. Immune dysfunction in patients with diabetes mellitus (DM). FEMS Immunol Med Microbiol 1999;26:256-65.
|
| 3. | Muller LM, Gorter KJ, Hak E, Goudzwaard WL, Schellevis FG, Hoepelman AI, et al. Increased risk of common infections in patients with type 1 and type 2 diabetes mellitus. Clin Infect Dis 2005;41:281-8.
|
| 4. | Peleg AY, Weerarathna T, McCarthy JS, Davis TM. Common infections in diabetes: Pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev 2007;23:3-13.
|
| 5. | Stoeckle M, Kaech C, Trampuz A, Zimmerli W. The role of diabetes mellitus in patients with bloodstream infections. Swiss Med Wkly 2008;138:512-9.
|
| 6. | Flyvbjerg A. Diabetic angiopathy, the complement system and the tumor necrosis factor superfamily. Nat Rev Endocrinol 2010;6:94-101.
|
| 7. | Geerlings SE, Brouwer EC, Van Kessel KC, Gaastra W, Stolk RP, Hoepelman AI. Cytokine secretion is impaired in women with diabetes mellitus. Eur J Clin Invest 2000;30:995-1001.
|
| 8. | Price CL, Al Hassi HO, English NR, Blakemore AI, Stagg AJ, Knight SC. Methylglyoxal modulates immune responses: relevance to diabetes. J Cell Mol Med 2010;14:1806-15.
|
| 9. | Nirmal J, Caputo GM, Weitekamp MR, Karchmer AW. Infections in patients with diabetes mellitus. N Engl J Med 1999;341:1906-12.
|
| 10. | Vardakas KZ, Siempos II, Falagas ME. Diabetes mellitus as a risk factor for nosocomial pneumonia and associated mortality. Diabet Med 2007;24:1168-71.
|
| 11. | American Diabetes Association (ADA). Standards of medical care in diabetes-2011. Diabetes Care 2011;33:S11-61.
|
| 12. | Cano M, Iglesias P, Pérez G, Díez JJ. Influenza A virus (H1N1) infection as a cause of severe diabetic ketoacidosis in type 1 diabetes. Endocrinol Nutr 2010;57:37-8.
|
| 13. | Centers for Disease Control and Prevention (CDC). Centers for Disease Control and Prevention (CDC). The Pink Book: Chapters Epidemiology and Prevention of Vaccine Preventable Diseases. 12 th Edition, April 2011. Available from: http://www.cdc.gov/vaccines/pubs/pinkbook/pink-chapters.htm [Last Accessed on 2011 Oct 12].
|
| 14. | Kornum JB, Thomsen RW, Riis A, Lervang HH, Schønheyder HC, Sørensen HT. Type 2 diabetes and pneumonia outcomes: A population-based cohort study. Diabetes Care 2007;30:2251-7.
|
| 15. | Barros MM, Cartagena SC, Bavestrello FL. Prevention of community-acquired pneumonia in adults. Rev Chilena Infectol 2005;22:s67-74.
|
| 16. | Rocha J, Baggio H, Cunha C, Niclewicz E, Leite S, Baptista M. Aspectos relevantes da interface entre diabetes mellitus e infecção. Arq Bras Endocrinol Metab 2002;46:221-9.
|
| 17. | Miller AC, Subranian RA, Safi F, Sinert R, Zehtabchi S, Elamin EM. Influenza A 2009 (H1N1) virus in admitted and critically ill patients. J Intensive Care Med 2011;27:25-31.
|
| 18. | Jain S, Kamimoto L, Bramley AM, Schmitz AM, Benoit SR, Louie J, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med 2009;361:1935-44.
|
| 19. | Aubert C, Vaudaux B, Bart PA. Immunization guidelines regarding patients with a chronic disease. Rev Med Suisse 2010;6:798-803.
|
| 20. | Giannattasio A, Squeglia V, Lo Vecchio A, Russo MT, Barbarino A, Carlomagno R, et al. Pneumococcal and influenza vaccination rates and their determinants in children with chronic medical conditions. Ital J Pediatr 2010;36:28.
|
| 21. | Restrepo BI, Camerlin AJ, Rahbar MH, Wang W, Restrepo MA, Zarate I, et al. Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases. Bull World Health Organ 2011;89:352-9.
|
| 22. | Harries AD, Lin Y, Satyanarayana S, Lönroth K, Li L, Wilson N, et al. The looming epidemic of diabetes-associated tuberculosis: learning lessons from the HIV-associated tuberculosis. Inter J Tuberc Lung Dis 2011;15:1436-45.
|
| 23. | Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: Convergence of two epidemics. Lancet Infect Dis 2009;9:737-46.
|
| 24. | Ruslami R, Aarniutse RE, Alisjahbana B, van der Ven AJ, van Crevel R. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health 2010;15:1289-99.
|
| 25. | Geerlings SE. Urinary tract infections in patients with diabetes mellitus: Epidemiology, pathogenesis and treatment. Int J Antimicrob Agents 2008;31S:S54-7.
|
| 26. | Ludwig E. Urinary tract infections in diabetes mellitus. Orv Hetil 2008;149:597-600.
|
| 27. | Hokkam EN. Assessment of risk factors in diabetic foot ulceration and their impact on the outcome of the disease. Prim Care Diab 2009;3:219-24.
|
| 28. | Stapleton A. Urinary tract infections in patients with diabetes. Am J Med 2002;113:80S-4S.
|
| 29. | Chen SL, Jackson SL, Boyko EJ. Diabetes mellitus and urinary tract infection: epidemiology, pathogenesis and proposed studies in animal models. J Urol 2009;182:S51-6.
|
| 30. | Papazafiropoulou A, Daniil I, Sotiropoulos A, Balampani E, Kokolaki A, Bousboulas S, et al. Prevalence of asymptomatic bacteriuria in type 2 diabetic subjects with and without microalbuminuria. BMC Res Notes 2010;3:169.
|
| 31. | Meiland R, Geerlings SE, Stolk RP, Netten PM, Schneeberger P, Hoepelman AI. Asymptomatic bacteriuria in women with diabetes mellitus: effect on renal function after 6 years of follow-up. Arch Intern Med 2006;166:2222-7.
|
| 32. | Calvet HM, Yoshikawa TT. Infections in diabetes. Infect Dis Clin North Am 2001;15:407-20.
|
| 33. | Krishnasamy PV, Liby C. Emphysematous pyelonephritis caused by Candida tropicalis. Am J Med 2010;123:e7-8.
|
| 34. | Mokabberi R, Ravakhah K. Emphysematous urinary tract infections: diagnosis, treatment and survival (case review series). Am J Med Sci 2007;333:111-6.
|
| 35. | Mohsin N, Budruddin M, Lala S, Al-Taie S. Emphysematous pyelonephritis: a case report series of four patients with review of literature. Ren Fail 2009;31:597-601.
|
| 36. | Pontin AR, Barnes RD. Current management of emphysematous pyelonephritis. Nat Rev Urol 2009;6:272-9.
|
| 37. | Yao J, Gutierrez OM, Reiser J. Emphysematous pyelonephritis. Kidney Int 2007;71:462-5.
|
| 38. | Falagas ME, Alexiou VG, Giannopoulou KP, Siempos II. Risk factors for mortality in patients with emphysematous pyelonephritis: a meta-analysis. J Urol 2007;178:880-5.
|
| 39. | Solak Y, Turkmen K, Atalay H, Turk S. Culture-negative bilateral emphysematous pyelonephritis presented as acute renal failure and managed medically only. South Med J 2010;103:154-5.
|
| 40. | Thomas AA, Lane BR, Thomas AZ, Remer EM, Campbell SC, Shoskes DA. Emphysematous cystitis: A review of 135 cases. BJU Int 2007;100:17-20.
|
| 41. | Etienne M, Caron F. Management of fungal urinary tract infections. Presse Med 2007;36(12 Pt 3):1899-906.
|
| 42. | Grupper M, Kravtsov A, Potasman I. Emphysematous cystitis: illustrative case report and review of the literature. Medicine 2007;86:47-53.
|
| 43. | Kelesidis T, Osman S, Tsiodras S. Emphysematous cystitis in the absence of known risk factors: An unusual clinical entity. South Med J 2009;102:942-6.
|
| 44. | Baena JF, Romeu JP, Llopis JA, Tamayo AL, Encinas JJ. Emphysematous cystitis. Case report and review of literature. Actas Urol Esp 2008;32:948-50.
|
| 45. | Fullá J, Storme O, Fica A, Varas MA, Flores J, Marchant F, et al. Renal and perinephric abscesses: A series of 44 cases. Rev Chilena Infectol 2009;26:445-51.
|
| 46. | Coelho RF, Schneider-Monteiro ED, Mesquita JL, Mazzucchi E, Marmo Lucon A, Srougi M. Renal and perinephric abscesses: analysis of 65 consecutive cases. World J Surg 2007;31:431-6.
|
| 47. | Maldonado-Alcaraz E, Ixquiac-Pineda G, López-Sámano V, Serrano-Brambila E. Perinephric abscess: Associated factors and mortality. Arch Esp Urol 2008;61:7-12.
|
| 48. | Tsukagoshi D, Dinkovski B, Dasan S, Jethwa J. Perinephric abscess secondary to a staghorn calculus presenting as a subcutaneous abscess. CJEM 2006;8:285-8.
|
| 49. | Rayner CK, Samsom M, Jones KL, Horowitz M. Relationships of upper gastrointestinal motor and sensory function with glycemic control. Diabetes Care 2001;24:371-81.
|
| 50. | Schimke K, Chubb SA, Davis WA, Philipst P, Davis TM. Antiplatelet therapy, Helicobacter pylori infection and complicated peptic ulcer disease in diabetes: The fremantle diabetes study. Diabet Med 2009;26:70-5.
|
| 51. | Papamichael KX, Papaioannou G, Karga H, Roussos A, Mantzaris GJ. Helicobacter pylori infection and endocrine disorders: is there a link?. World J Gastroenterol 2009;15:2701-7.
|
| 52. | Gunji T, Matsuhashi N, Sato H, Fujibayashi K, Okumura M, Sasabe N, et al. Helicobacter pylori infection significantly increases insulin resistance in the asymptomatic Japanese population. Helicobacter 2009;14:144-50.
|
| 53. | Candelli M, Rigante D, Marietti G, Nista EC, Crea F, Bartolozzi F, et al. Helicobacter pylori, gastrointestinal symptoms, and metabolic control in young type 1 diabetes mellitus patients. Pediatrics 2003;111(4 Pt 1):800-3.
|
| 54. | Ojetti V, Pellicano R, Fagoonee S, Migneco A, Berrutti M, Gasbarrini A. Helicobacter pylori infection and diabetes. Minerva Med 2010;101:115-9.
|
| 55. | Menezes EA, Augusto KL, Freire CC, Cunha FA, Montenegro RM, Montenegro-Júnior RM. Frequency and enzymatic activity of Candida spp. oral cavity of diabetic patients of the service of endocrinology of a hospital of Fortaleza-CE. J Bras Patol Med Lab 2007;43:241-4.
|
| 56. | Jadoon NA, Shahzad MA, Yaqoob R, Hussain M, Ali N. Seroprevalence of hepatitis C in type 2 diabetes: Evidence for a positive association. Virol J 2010;7:304.
|
| 57. | Elhawary EI, Mahmoud GF, El-Daly MA, Mekky FA, Esmat GG, Abdel-Hamid M. Association of UVV with diabetes mellitus: an Egyptian case-control study. Virol J 2011;8:367.
|
| 58. | Negro F, Alaei M. Hepatitis C virus and type2 diabetes. World J Gastroenterol 2009;15:1357-47.
|
| 59. | Petit JM, Bour JB, Galland-Jos C, Minello A, Verges B, Guiguet M. Risk factors for diabetes mellitus and insulin resistance in chronic hepatitis C. J Hepatology 2001;35:279-83.
|
| 60. | Gutiérrez-Grobe Y, Ponciano-Rodriguez G, Méndez-Sanchez N. Viral hepatitis infection and insulin resistance: A review of pathophysiological mechanisms. Salud Pub Mex 2010;53:S46-51.
|
| 61. | Demir M, Serin E, Göktürk S, Ozturk NA, Kulaksizoglu S, Ylmaz U. The prevalence of occult hepatitis B virus infection in type 2 diabetes mellitus patients. Eu J Gastroenterol Hepatol 2008;20:668-73.
|
| 62. | Huang ZS, Huang TS, Wu TH, Chen MF, Hsu CS, Kai JH. Asymptomatic chronic hepatitis B virus infection does not increase the risk of diabetes mellitus: A ten-year observation. J Gastroenterol Hepatol 2010;25:1420-5.
|
| 63. | Lao TT, Chan BC, Leung WC, Ho LF, Tse KY. Maternal hepatitis B infection and gestational diabetes mellitus. J Hepatol 2007;47:46-50.
|
| 64. | Thomson ND, Perz JF. Eliminating the blood: ongoing outbreaks of hepatitis B virus infection and the need for innovative glucose monitoring technologies. J Diabetes Sci Technol 2009;3:283-8.
|
| 65. | Hober D. Enteroviral pathogenesis of type 1 diabetes. Discov Med 2010;10:151-60.
|
| 66. | Stene LC, Oikarinen S, Hyöty H, Barriga KJ, Norris JM, Klingensmith G, et al. Enterovirus infection and progression from islet autoimmunity to type 1 diabetes. The Diabetes and Autoimmunity Study in the Young (DAISY). Diabetes 2010;59:3174-80.
|
| 67. | Lipsky BA, Tabak YP, Johannes RS, Vo L, Hyde L, Weigelt JA. Skin and soft tissue infections in hospitalized patients with diabetes: Culture isolates and risk factors associated with mortality, length of stay and cost. Diabetologia 2010;53:914-23.
|
| 68. | Ahmed I, Goldstein B. Diabetes mellitus. Clin Dermatol 2006;24:237-46.
|
| 69. | Fincke BG, Miller DR, Christiansen CL, Turpin RS. Variation in antibiotic treatment for diabetic patients with serious foot infections: A retrospective observational study. BMC Health Serv Res 2010;10:193.
|
| 70. | Nicolau DP, Stein GE. Therapeutic options for diabetic foot infections: a review with an emphasis on tissue penetration characteristics. J Am Podiatr Med Assoc 2010;100:52-63.
|
| 71. | Powlson AS, Coll AP. The treatment of diabetic foot infections. J Antimicrob Chemother 2010;65 Suppl 3:iii3-9.
|
| 72. | Joseph WS, Lipsky BA. Medical therapy of diabetic foot infections. J Vasc Surg 2010;52 Suppl 3:67S-71.
|
| 73. | Zhang WJ, Cai XY, Yang C, Zhou LN, Cai M, Lu XF, et al. Cervical necrotizing fasciitis due to methicillin-resistant Staphylococcus aureus: A case report. Int J Oral Maxillofac Surg 2010;39-830-4.
|
| 74. | Oguz H, Demirci M, Arslan N, Safak MA, Paksoy G. Necrotizing fasciitis of the head and neck: Report of two cases and literature review. Ear Nose Throat J 2010;89:E7-10.
|
| 75. | Shaikh N, Ummunissa F, Hanssen Y, Al Makki H, Shokr HM. Hospital epidemiology of emergent cervical necrotizing fasciitis. J Emerg Trauma Shock 2010;3:123-5.
[PUBMED] |
| 76. | Shimizu T, Tokuda Y. Necrotizing fasciitis. Intern Med J 2010;49:1051-7.
|
| 77. | Tran HA, Hart AM. Fournier's gangrene. Intern Med J 2006;36:200-1.
|
| 78. | Montoya Chinchilla R, Izquierdo Morejon E, Nicolae Pietricicâ B, Pellicer Franco E, Aguayo Albasini JL, Miñana López B. Fournier's gangrene. Descriptive analysis of 20 cases and literature review. Actas Urol Esp 2009;33:873-80.
|
| 79. | Carfrae MJ, Kesser BW. Malignant otitis externa. Otolaryngol Clin North Am 2008;41:537-49.
|
| 80. | Artal R, Agreda B, Serrano E, Alfonso JI, Vallés H. Rhinocerebral mucormycosis: Report on eight cases. Acta Otorrinolaringol Esp 2010;61:301-5.
|
| 81. | Giuliani A, Mettimano M, Viviani D, Scagliusi A, Bruno A, Russo A, et al. An uncommon case of systemic mucormycosis associated with spinal cord infarction in a recently diagnosed diabetic. Int J Immunopathol Pharmacol 2010;23:355-8.
|
| 82. | Severo CB, Guazzelli LS, Severo LC. Zigomicose. J Bras Pneumol 2010;36:134-41.
|
| 83. | Liu M, Spellberg B, Phan QT, Fu Y, Fu Y, Lee AS, et al. The endothelial cell receptor GRP78 is required for mucormycosis pathogenesis in diabetic mice. J Clin Invest 2010;120:1914-24.
|
| 84. | Alves C, Andion J, Brandão M, Menezes R. Pathogenic aspects of the periodontal disease associated to diabetes mellitus. Arq Bras Endocrinol Metab 2007;51:1050-7.
|
| 85. | Nagasawa T, Noda M, Katagiri S, Takaichi M, Takahashi Y, Wara-Aswapati N, et al. Relationship between periodontitis and diabetes - importance of a clinical study to prove the vicious cycle. Intern Med 2010;49:881-5.
|
| 86. | Simpson TC, Needleman I, Wild SH, Moles DR, Mills EJ. Treatment of periodontal disease for glycaemic control in people with diabetes. Cochrane Database Syst Rev 2010;5:CD004714.
|
| 87. | Kalra S, Kalra B, Agrawal N, Unnikrishnan AG. Understanding diabetes in patients with HIV/AIDS. Diabetol Metab Syndr 2011;3:2.
|
| 88. | Alves C, Oliveira AC, Brites C. Lipodystrophic syndrome in children and adolescents infected with the human immunodeficiency virus. Braz J Infect Dis 2008;12:342-8.
|
| 89. | Takarabe D, Rokukawa Y, Takahashi Y, Goto A, Talkaichi M, Okamoto M, et al. Autoimmune diabetes in HIV-infected patients on highly active antiretroviral therapy. J Clin Endocrinol Metab 2010;95:4056-60.
|
| 90. | Van der Werf N, Kroese FG, Rozing J, Hillebrands JL. Viral infections as potential trigger of type 1 diabetes. Diabetes Metab Res Rev 2007;23:169-83.
|
[Figure 1]
[Table 1], [Table 2], [Table 3]
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|
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COVID-19 and endocrine diseases. A statement from the European Society of Endocrinology |
|
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|
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|
| Brent Wise,Renan Castillo,Manjari Joshi,Robert V. O’Toole | | Techniques in Orthopaedics. 2020; 35(2): 100 | | [Pubmed] | [DOI] | | | 39 |
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|
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|
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COVID-19 and diabetes: The why, the what and the how |
|
| Sarah Cuschieri,Stephan Grech | | Journal of Diabetes and its Complications. 2020; : 107637 | | [Pubmed] | [DOI] | | | 42 |
Finegoldia magna, an Anaerobic Gram-Positive Bacterium of the Normal Human Microbiota, Induces Inflammation by Activating Neutrophils |
|
| Ariane Neumann,Lars Björck,Inga-Maria Frick | | Frontiers in Microbiology. 2020; 11 | | [Pubmed] | [DOI] | | | 43 |
The perils of perioperative dysglycemia |
|
| Micah T. Long,Douglas B. Coursin | | International Anesthesiology Clinics. 2020; 58(1): 21 | | [Pubmed] | [DOI] | | | 44 |
Impact of Diabetes Mellitus on Radiological Presentation of Pulmonary Tuberculosis in Otherwise Non-Immunocompromised Patients: A Systematic Review |
|
| Mohammad Ishraq Zafar,Lu-Lu Chen,Ye Xiaofeng,Feng Gao | | Current Medical Imaging Formerly Current Medical Imaging Reviews. 2019; 15(6): 543 | | [Pubmed] | [DOI] | | | 45 |
Risk factor analysis on the healing time and infection rate of diabetic foot ulcers in a referral wound care clinic |
|
| Khaw Kher Kee,Harikrishna K. R. Nair,Ng Pei Yuen | | Journal of Wound Care. 2019; 28(Sup1): S4 | | [Pubmed] | [DOI] | | | 46 |
Stability Preserving Non-Standard Finite Difference Schemes for Diabetes with Tuberculosis Infectious Model |
|
| P. Danumjaya,Merina Dhara | | Letters in Biomathematics. 2019; 6(2) | | [Pubmed] | [DOI] | | | 47 |
Analysis of Risk Factors for Infection in Orthopedic Trauma Patients |
|
| Gi Ho Moon,Jae-Woo Cho,Beom Soo Kim,Do Hyun Yeo,Jong-Keon Oh | | Journal of Trauma and Injury. 2019; 32(1): 40 | | [Pubmed] | [DOI] | | | 48 |
MACROPHAGES FROM A TYPE 1 DIABETES MOUSE MODEL PRESENT DYSREGULATED PI3K/AKT, ERK 1/2 AND SAPK/JNK LEVELS |
|
| Fernando Henrique Galvão Tessaro,Thais Soprani Ayala,Leonardo Mendes Bella,Joilson Oliveira Martins | | Immunobiology. 2019; | | [Pubmed] | [DOI] | | | 49 |
Kontrolsüz Diyabetes Mellitus Vakasinda Nadir Görülen Amfizematöz Piyelonefrit ile Sistit Birlikteligi: Vaka Raporu ve Literatür derlemesi |
|
| Hamit YILDIZ | | Kahramanmaras Sütçü Imam Üniversitesi Tip Fakültesi Dergisi. 2019; | | [Pubmed] | [DOI] | | | 50 |
Evaluating All Potential Oral Complications of Diabetes Mellitus |
|
| Martijn J. L. Verhulst,Bruno G. Loos,Victor E. A. Gerdes,Wijnand J. Teeuw | | Frontiers in Endocrinology. 2019; 10 | | [Pubmed] | [DOI] | | | 51 |
Influence of preoperative hemoglobin A1c on early outcomes in patients with diabetes mellitus undergoing off-pump coronary artery bypass surgery |
|
| Hye Jin Kim,Jae-Kwang Shim,Young-Nam Youn,Jong-Wook Song,Haeyeon Lee,Young-Lan Kwak | | The Journal of Thoracic and Cardiovascular Surgery. 2019; | | [Pubmed] | [DOI] | | | 52 |
Immunometabolism and Pulmonary Infections: Implications for Protective Immune Responses and Host-Directed Therapies |
|
| Martin Rao,Ernest Dodoo,Alimuddin Zumla,Markus Maeurer | | Frontiers in Microbiology. 2019; 10 | | [Pubmed] | [DOI] | | | 53 |
Immunological Impacts of Diabetes on the Susceptibility of Mycobacterium tuberculosis |
|
| Birhanu Ayelign,Markos Negash,Meaza Genetu,Tadelo Wondmagegn,Tewodros Shibabaw | | Journal of Immunology Research. 2019; 2019: 1 | | [Pubmed] | [DOI] | | | 54 |
Serum Interleukin-8 in Patients with Different Origin of Intra-Abdominal Infections in Perioperative Period |
|
| Artem Riga,Valeriy Boyko,Yuriy Grirorov | | Medical Sciences. 2019; 7(9): 94 | | [Pubmed] | [DOI] | | | 55 |
Validated 60-Second General Foot Screen |
|
| R. Gary Sibbald,Khalad Maliyar,Reneeka Persaud-Jaimangal,James A. Elliott,Alisa Brandon,Bharat Kotru,David G. Armstrong | | Advances in Skin & Wound Care. 2019; 32(11): 490 | | [Pubmed] | [DOI] | | | 56 |
Escherichia coli Bloodstream Infections in Patients at a University Hospital: Virulence Factors and Clinical Characteristics |
|
| Ana Paula Daga,Vanessa Lumi Koga,João Gabriel Material Soncini,Caroline Martins de Matos,Marcia Regina Eches Perugini,Marsileni Pelisson,Renata Katsuko T. Kobayashi,Eliana Carolina Vespero | | Frontiers in Cellular and Infection Microbiology. 2019; 9 | | [Pubmed] | [DOI] | | | 57 |
Hand Hygiene Practices Among Adults with Diabetes Living in Communities: The 2015 Korea Community Health Survey |
|
| Mi Ah Han | | International Journal of Environmental Research and Public Health. 2019; 16(7): 1279 | | [Pubmed] | [DOI] | | | 58 |
Dual Gene Expression Analysis Identifies Factors Associated with Staphylococcus aureus Virulence in Diabetic Mice |
|
| Rudy Jacquet,Annette E. LaBauve,Lavoisier Akoolo,Shivani Patel,Abdulelah A. Alqarzaee,Tania Wong Fok Lung,Kunal Poorey,Timothy P. Stinear,Vinai C. Thomas,Robert J. Meagher,Dane Parker,Victor J. Torres | | Infection and Immunity. 2019; 87(5) | | [Pubmed] | [DOI] | | | 59 |
Kardiyak cerrahi sonrasi gelisen saglik bakimi ile iliskili enfeksiyonlarin degerlendirilmesi-tek merkez deneyimi |
|
| Zehra Çagla Karakoç | | Dicle Tip Dergisi. 2019; : 461 | | [Pubmed] | [DOI] | | | 60 |
Diabetes and Phacoemulsification Cataract Surgery: Difficulties, Risks and Potential Complications |
|
| Andrzej Grzybowski,Piotr Kanclerz,Valentín Huerva,Francisco J. Ascaso,Raimo Tuuminen | | Journal of Clinical Medicine. 2019; 8(5): 716 | | [Pubmed] | [DOI] | | | 61 |
Stability preserving non-standard finite difference schemes for diabetes with tuberculosis infectious model |
|
| P. Danumjaya,Merina Dhara | | Letters in Biomathematics. 2019; : 1 | | [Pubmed] | [DOI] | | | 62 |
Bisifusarium Delphinoides, an Emerging Opportunistic Pathogen in a Burn Patient with Diabetes Mellitus |
|
| Ji-Hyun Park,Junsang Oh,Ji-Sun Song,Jayoung Kim,Gi-Ho Sung | | Mycobiology. 2019; : 1 | | [Pubmed] | [DOI] | | | 63 |
Diffuse Lymph-Nodes Microangiopathy as Concurrent Cause of Immunodeficiency in Long-Term Insulin-Dependent Diabetic Patients |
|
| Pietro Muretto | | Journal of Obesity and Diabetes. 2019; : 25 | | [Pubmed] | [DOI] | | | 64 |
Prognostic Significance of “Nonsolid” Microscopic Metastasis in Merkel Cell Carcinoma Sentinel Lymph Nodes |
|
| Emily M. Erstine,Michael T. Tetzlaff,Xuefei Jia,Phyu P. Aung,Victor G. Prieto,Pauline Funchain,Brian R. Gastman,Steven D. Billings,Jennifer S. Ko | | The American Journal of Surgical Pathology. 2019; 43(7): 907 | | [Pubmed] | [DOI] | | | 65 |
Associations of cutaneous and extracutaneous infections with hidradenitis suppurativa in U.S. children and adults |
|
| H.H. Lee,K.R. Patel,V. Singam,S. Rastogi,J.I. Silverberg | | British Journal of Dermatology. 2019; | | [Pubmed] | [DOI] | | | 66 |
Comparison of fluconazole and itraconazole for treatment of rhinomaxillary mucormycosis |
|
| Omer sefvan Janjua,Sarah Shah,Ammara Afzal,Sana Mehmood Qureshi | | Journal of Surgery and Medicine. 2019; | | [Pubmed] | [DOI] | | | 67 |
Hyperglycemia as a Risk Factor for Postoperative Early Wound Infection after Bicondylar Tibial Plateau Fractures: Determining a Predictive Model Based on Four Methods |
|
| Andres Rodriguez-Buitrago,Attum Basem,Ebubechi Okwumabua,Nichelle Enata,Adam Evans,Jacquelyn Pennings,Bernes Karacay,Mark John Rice,William Obremskey | | Injury. 2019; | | [Pubmed] | [DOI] | | | 68 |
Plasmodium Infection Induces Dyslipidemia and a Hepatic Lipogenic State in the Host through the Inhibition of the AMPK-ACC Pathway |
|
| George Eduardo Gabriel Kluck,Camila Hübner Costabile Wendt,Guinever Eustaquio do Imperio,Maria Fernanda Carvalho Araujo,Tainá Correa Atella,Isabella da Rocha,Kildare Rocha Miranda,Georgia Correa Atella | | Scientific Reports. 2019; 9(1) | | [Pubmed] | [DOI] | | | 69 |
In Vitro and In Vivo Antimicrobial Activity of Antibiotic-Conjugated Carriers with Rapid pH-Responsive Release Kinetics |
|
| Sunyoung Kang,Gee Ho Park,Seulah Kim,Jungah Kim,Yoonhwa Choi,Yan Huang,Yan Lee,Tae Hyun Choi | | Advanced Healthcare Materials. 2019; : 1900247 | | [Pubmed] | [DOI] | | | 70 |
A novel impedance sensing approach for precise electromechanical characterization of cells |
|
| Karthik Mahesh,Manoj M Varma,Prosenjit Sen | | Journal of Micromechanics and Microengineering. 2019; 29(11): 115001 | | [Pubmed] | [DOI] | | | 71 |
Pharmacotherapy of Lower Respiratory Tract Infections in Elderly—Focused on Antibiotics |
|
| Yang Liu,Yan Zhang,Wanyu Zhao,Xiaolei Liu,Fengjuan Hu,Birong Dong | | Frontiers in Pharmacology. 2019; 10 | | [Pubmed] | [DOI] | | | 72 |
The rash in life-threatening metabolic and endocrine disorders |
|
| Fatima N. Mirza,Jonathan S. Leventhal | | Clinics in Dermatology. 2019; | | [Pubmed] | [DOI] | | | 73 |
Antidiabetic, antioxidant and antimicrobial activity of the aerial part of Tiliacora triandra |
|
| E.A. Makinde,C. Ovatlarnporn,A.E. Adekoya,O.F. Nwabor,O.J. Olatunji | | South African Journal of Botany. 2019; 125: 337 | | [Pubmed] | [DOI] | | | 74 |
Inhibitory effects of selected antibiotics on the activities of a-amylase and a-glucosidase: In-vitro, in-vivo and theoretical studies |
|
| Bita Amiri,Najmeh Sadat Hosseini,Fatemeh Taktaz,Komail Amini,Mehdi Rahmani,Mehdi Amiri,Komail Sadrjavadi,Abolfazl Jangholi,Sajjad Esmaeili | | European Journal of Pharmaceutical Sciences. 2019; 138: 105040 | | [Pubmed] | [DOI] | | | 75 |
Diabetes does not increase infection risk or mortality following an infection in patients with cirrhosis and ascites |
|
| Lars Bossen,Gitte A. Dam,Hendrik Vilstrup,Hugh Watson,Peter Jepsen | | JHEP Reports. 2019; | | [Pubmed] | [DOI] | | | 76 |
Infections in the diabetic child |
|
| Luis Eduardo Calliari,Flávia J. Almeida,Renata Maria Noronha | | Jornal de Pediatria. 2019; | | [Pubmed] | [DOI] | | | 77 |
Forecasting the impact of diabetes mellitus on tuberculosis disease incidence and mortality in India |
|
| Susanne F Awad,Peijue Huangfu,Houssein H Ayoub,Fiona Pearson,Soha R Dargham,Julia A Critchley,Laith J Abu-Raddad | | Journal of Global Health. 2019; 9(2) | | [Pubmed] | [DOI] | | | 78 |
Incidence of Cellulitis in Lower Extremity Burns |
|
| Joseph N. Batac,Roger L. Simpson,Catherine J. Sinnott,Michael P. Catanzaro,Laurence T. Glickman | | Annals of Plastic Surgery. 2018; : 1 | | [Pubmed] | [DOI] | | | 79 |
Perioperative Considerations to Reduce Infection Risk in Primary Total Hip and Knee Arthroplasty |
|
| Michael J. DeRogatis,Annalisse M. Mahon,Patrick Lee,Paul S. Issack | | JBJS Reviews. 2018; 6(4): e8 | | [Pubmed] | [DOI] | | | 80 |
Severe ischemic cytomegalovirus proctocolitis with multiple perforation |
|
| Reuban Toby D’cruz,Cheryl Chien-Li Lau,Thomas Paulraj Thamboo | | Archives of Virology. 2018; | | [Pubmed] | [DOI] | | | 81 |
Fulminant mucormycosis of maxillary sinuses after dental extraction inpatients with uncontrolled diabetic: Two case reports |
|
| N. Gholinejad Ghadi,Z. Seifi,T. Shokohi,S.R. Aghili,M. Nikkhah,L. Vahedi Larijani,M. Ghasemi,I. Haghani | | Journal de Mycologie Médicale. 2018; | | [Pubmed] | [DOI] | | | 82 |
Multi-centre prospective internal and external evaluation of the Brompton Harefield Infection Score (BHIS) |
|
| Melissa Rochon,Julian WE Jarman,Joseph Gabriel,Lisa Butcher,Carlos Morais,Martin Still,Ishtiaq Ahmed,Mario Petrou,Richard Trimlett,Anthony DeSouza,Rashmi Yadav,Shahzad G Raja | | Journal of Infection Prevention. 2018; 19(2): 74 | | [Pubmed] | [DOI] | | | 83 |
Hyperglycemia drives intestinal barrier dysfunction and risk for enteric infection |
|
| Christoph A. Thaiss,Maayan Levy,Inna Grosheva,Danping Zheng,Eliran Soffer,Eran Blacher,Sofia Braverman,Anouk C. Tengeler,Oren Barak,Maya Elazar,Rotem Ben-Zeev,Dana Lehavi-Regev,Meirav N. Katz,Meirav Pevsner-Fischer,Arieh Gertler,Zamir Halpern,Alon Harmelin,Suhail Aamar,Patricia Serradas,Alexandra Grosfeld,Hagit Shapiro,Benjamin Geiger,Eran Elinav | | Science. 2018; 359(6382): 1376 | | [Pubmed] | [DOI] | | | 84 |
Epidemiology and Immune Pathogenesis of Viral Sepsis |
|
| Gu-Lung Lin,Joseph P. McGinley,Simon B. Drysdale,Andrew J. Pollard | | Frontiers in Immunology. 2018; 9 | | [Pubmed] | [DOI] | | | 85 |
Glycemic Control and Risk of Infections Among People With Type 1 or Type 2 Diabetes in a Large Primary Care Cohort Study |
|
| Julia A. Critchley,Iain M. Carey,Tess Harris,Stephen DeWilde,Fay J. Hosking,Derek G. Cook | | Diabetes Care. 2018; 41(10): 2127 | | [Pubmed] | [DOI] | | | 86 |
Data-Driven Blood Glucose Pattern Classification and Anomalies Detection: Machine Learning Applications in Type 1 Diabetes (Preprint) |
|
| Ashenafi Zebene Woldaregay,Eirik Årsand,Taxiarchis Botsis,David Albers,Lena Mamykina,Gunnar Hartvigsen | | Journal of Medical Internet Research. 2018; | | [Pubmed] | [DOI] | | | 87 |
Linagliptin Attenuates the Cardiac Dysfunction Associated With Experimental Sepsis in Mice With Pre-existing Type 2 Diabetes by Inhibiting NF-?B |
|
| Sura Al Zoubi,Jianmin Chen,Catherine Murphy,Lukas Martin,Fausto Chiazza,Debora Collotta,Muhammad M. Yaqoob,Massimo Collino,Christoph Thiemermann | | Frontiers in Immunology. 2018; 9 | | [Pubmed] | [DOI] | | | 88 |
Positive Bacteriological Analyses in Individuals With Diabetes Mellitus |
|
| Cristian Palmiere,Camilla Tettamanti | | The American Journal of Forensic Medicine and Pathology. 2018; 39(2): 126 | | [Pubmed] | [DOI] | | | 89 |
Prevalence of chronic comorbidities in dengue fever and West Nile virus: A systematic review and meta-analysis |
|
| Alaa Badawi,Russanthy Velummailum,Seung Gwan Ryoo,Arrani Senthinathan,Sahar Yaghoubi,Denitsa Vasileva,Emma Ostermeier,Mikayla Plishka,Marcel Soosaipillai,Paul Arora,Pierre Roques | | PLOS ONE. 2018; 13(7): e0200200 | | [Pubmed] | [DOI] | | | 90 |
Acting on non-communicable diseases in low- and middle-income tropical countries |
|
| Majid Ezzati,Jonathan Pearson-Stuttard,James E. Bennett,Colin D. Mathers | | Nature. 2018; | | [Pubmed] | [DOI] | | | 91 |
Risk of Infection in Type 1 and Type 2 Diabetes Compared With the General Population: A Matched Cohort Study |
|
| Iain M. Carey,Julia A. Critchley,Stephen DeWilde,Tess Harris,Fay J. Hosking,Derek G. Cook | | Diabetes Care. 2018; 41(3): 513 | | [Pubmed] | [DOI] | | | 92 |
The Role of Allograft Inflammatory Factor-1 in the Effects of Experimental Diabetes on B Cell Functions in the Heart |
|
| Amrita Sarkar,Sanket K. Shukla,Aseel Alqatawni,Anil Kumar,Sankar Addya,Alexander Y. Tsygankov,Khadija Rafiq | | Frontiers in Cardiovascular Medicine. 2018; 5 | | [Pubmed] | [DOI] | | | 93 |
Remodeling of Retinal Architecture in Diabetic Retinopathy: Disruption of Ocular Physiology and Visual Functions by Inflammatory Gene Products and Pyroptosis |
|
| Rubens P. Homme,Mahavir Singh,Avisek Majumder,Akash K. George,Kavya Nair,Harpal S. Sandhu,Neetu Tyagi,David Lominadze,Suresh C Tyagi | | Frontiers in Physiology. 2018; 9 | | [Pubmed] | [DOI] | | | 94 |
High Risk of Deep Neck Infection in Patients with Type 1 Diabetes Mellitus: A Nationwide Population-Based Cohort Study |
|
| Geng-He Chang,Meng-Chang Ding,Yao-Hsu Yang,Yung-Hsiang Lin,Chia-Yen Liu,Meng-Hung Lin,Ching-Yuan Wu,Cheng-Ming Hsu,Ming-Shao Tsai | | Journal of Clinical Medicine. 2018; 7(11): 385 | | [Pubmed] | [DOI] | | | 95 |
Concurrent Use of Sulfonylureas and Antimicrobials of the Elderly in Korea: A Potential Risk of Hypoglycemia |
|
| Sera Lee,Miyoung Ock,Hyunah Kim | | Korean Journal of Clinical Pharmacy. 2018; 28(3): 188 | | [Pubmed] | [DOI] | | | 96 |
Rhinocerebral Mucormycosis in a Patient with Diabetes Type 1 Presenting as Ptosis and Facial Palsy Report from Alborz Hospital of Karaj from Iran |
|
| Leila Kheirkhah | | International Clinical Pathology Journal. 2017; 5(2) | | [Pubmed] | [DOI] | | | 97 |
Analysis of factors influencing survival in patients with severe acute pancreatitis |
|
| Yeon Ji Kim,Dae Bum Kim,Woo Chul Chung,Ji Min Lee,Gun Jung Youn,Yun Duk Jung,Sooa Choi,Jung Hwan Oh | | Scandinavian Journal of Gastroenterology. 2017; : 1 | | [Pubmed] | [DOI] | | | 98 |
Alterations of Urinary Microbiota in Type 2 Diabetes Mellitus with Hypertension and/or Hyperlipidemia |
|
| Fengping Liu,Zongxin Ling,Yonghong Xiao,Qing Yang,Baohong Wang,Li Zheng,Ping Jiang,Lanjuan Li,Wei Wang | | Frontiers in Physiology. 2017; 8 | | [Pubmed] | [DOI] | | | 99 |
Chemical Constituents and Biological Activities of Essential Oils of Hydnora africana Thumb Used to Treat Associated Infections and Diseases in South Africa |
|
| Olubunmi Wintola,Anthony Afolayan | | Applied Sciences. 2017; 7(5): 443 | | [Pubmed] | [DOI] | | | 100 |
Not Only Glycaemic But Also Other Metabolic Factors Affect T Regulatory Cell Counts and Proinflammatory Cytokine Levels in Women with Type 1 Diabetes |
|
| Katerina Stechova,Jana Sklenarova-Labikova,Tereza Kratzerova,Pavlina Pithova,Dominik Filipp | | Journal of Diabetes Research. 2017; 2017: 1 | | [Pubmed] | [DOI] | | | 101 |
Subcutaneous implantable cardioverter-defibrillator Post-Approval Study: Clinical characteristics and perioperative results |
|
| Michael R. Gold,Johan D. Aasbo,Mikhael F. El-Chami,Mark Niebauer,John Herre,Jordan M. Prutkin,Bradley P. Knight,Steven Kutalek,Kevin Hsu,Raul Weiss,Eric Bass,Michael Husby,Timothy M. Stivland,Martin C. Burke | | Heart Rhythm. 2017; | | [Pubmed] | [DOI] | | | 102 |
Microbial Degradation of Forensic Samples of Biological Origin: Potential Threat to Human DNA Typing |
|
| Hirak Ranjan Dash,Surajit Das | | Molecular Biotechnology. 2017; | | [Pubmed] | [DOI] | | | 103 |
Impact of diabetes on free flap surgery of the head and neck: A NSQIP analysis |
|
| Jacob S. Brady,Aparna Govindan,Meghan M. Crippen,Andrey Filimonov,Jean Anderson Eloy,Soly Baredes,Richard Chan Woo Park | | Microsurgery. 2017; | | [Pubmed] | [DOI] | | | 104 |
Glycated Hemoglobin and Risk of Sternal Wound Infection After Isolated Coronary Surgery |
|
| Giuseppe Gatti,Andrea Perrotti,Daniel Reichart,Luca Maschietto,Francesco Onorati,Sidney Chocron,Magnus Dalén,Peter Svenarud,Giuseppe Faggian,Giuseppe Santarpino,Theodor Fischlein,Aniello Pappalardo,Daniele Maselli,Carmelo Dominici,Saverio Nardella,Antonino S. Rubino,Marisa De Feo,Francesco Santini,Francesco Nicolini,Riccardo Gherli,Giovanni Mariscalco,Tuomas Tauriainen,Eeva-Maija Kinnunen,Vito G. Ruggieri,Matteo Saccocci,Fausto Biancari | | Circulation Journal. 2017; 81(1): 36 | | [Pubmed] | [DOI] | | | 105 |
Effects of glycosylated hemoglobin levels on neutrophilic phagocytic functions |
|
| Michelle Shodja Mary,Knutsen Raymond,Cao Jeffrey,Oda Keiji,Beeson.W. Lawrence,Fraser. E. Gary,Knutsen Synnove | | Journal of Diabetes and Endocrinology. 2017; 8(2): 9 | | [Pubmed] | [DOI] | | | 106 |
Outcomes following repair of incarcerated and strangulated ventral hernias with or without synthetic mesh |
|
| Sameh Hany Emile,Hesham Elgendy,Ahmad Sakr,Waleed Ahmed Gado,Ahmed Aly Abdelmawla,Mahmoud Abdelnaby,Alaa Magdy | | World Journal of Emergency Surgery. 2017; 12(1) | | [Pubmed] | [DOI] | | | 107 |
High prevalence of candiduria due to non-albicans Candida
species among diabetic patients: A matter of concern? |
|
| Alireza Esmailzadeh,Hossein Zarrinfar,AbdolMajid Fata,Tanuka Sen | | Journal of Clinical Laboratory Analysis. 2017; : e22343 | | [Pubmed] | [DOI] | | | 108 |
Diabetes and Sepsis: Risk, Recurrence, and Ruination |
|
| Lynn M. Frydrych,Fatemeh Fattahi,Katherine He,Peter A. Ward,Matthew J. Delano | | Frontiers in Endocrinology. 2017; 8 | | [Pubmed] | [DOI] | | | 109 |
Dysbiosis of urinary microbiota is positively correlated with Type 2 diabetes mellitus |
|
| Fengping Liu,Zongxin Ling,Yonghong Xiao,Longxian Lv,Qing Yang,Baohong Wang,Haifeng Lu,Li Zheng,Ping Jiang,Wei Wang,Lanjuan Li | | Oncotarget. 2017; 8(3): 3798 | | [Pubmed] | [DOI] | | | 110 |
Whole-genome expression analyses of type 2 diabetes in human skin reveal altered immune function and burden of infection |
|
| Chun Wu,Xiaopan Chen,Jing Shu,Chun-Ting Lee | | Oncotarget. 2017; 8(21): 34601 | | [Pubmed] | [DOI] | | | 111 |
Mice with Streptozotocin-Induced Hyperglycemia are Susceptible to Invasive Enteric Bacterial Infection |
|
| Hemanta Koley,Poushali Ghosh,Ritam Sinha,Soma Mitra,Priyadarshini Mukherjee,Debaki Ranjan Howlader,Chandrima Chaki,Dhrubajyoti Nag | | Japanese Journal of Infectious Diseases. 2017; 70(1): 111 | | [Pubmed] | [DOI] | | | 112 |
ANTIBIOGRAM OF PREVALENT MICROORGANISMS IN WOUND INFECTIONS- A COMPARATIVE STUDY BETWEEN DIABETIC AND NON-DIABETIC PATIENTS ATTENDING A TERTIARY CARE HOSPITAL |
|
| Yusra Fatima,Maimoona Mustafa | | Journal of Evolution of Medical and Dental Sciences. 2017; 6(85): 5924 | | [Pubmed] | [DOI] | | | 113 |
Osteonecrosis of the jaw unrelated to medication or radiotherapy |
|
| Yusuf Gadiwalla,Vinod Patel | | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2017; | | [Pubmed] | [DOI] | | | 114 |
Immune and vascular dysfunction in diabetic wound healing |
|
| A.S. Ahmed,E.L. Antonsen | | Journal of Wound Care. 2016; 25(Sup7): S35 | | [Pubmed] | [DOI] | | | 115 |
Urinary infection due to Balantioides coli: a rare accidental zoonotic disease in an addicted and diabetic young female in Iran |
|
| Abdolghayyoum Movahhedi Roudi,Saman Soleimanpour,Seyedeh Sara Raeisalsadati,Ali Babaei | | JMM Case Reports. 2016; 3(1) | | [Pubmed] | [DOI] | | | 116 |
The Effect of Short-Term Hyperglycemia on the Innate Immune System |
|
| Nagham Jafar,Hawa Edriss,Kenneth Nugent | | The American Journal of the Medical Sciences. 2016; 351(2): 201 | | [Pubmed] | [DOI] | | | 117 |
Respiratory Burst Process in Diabetic Children |
|
| Anahita Sanaei Dashti,Soodabeh Taheri,Reza Jouybar,Mohammadreza Hashemnia,Abdollah Karimi,Seyed Abdolmajid Shoja | | Iranian Journal of Pediatrics. 2016; In Press(In Press) | | [Pubmed] | [DOI] | | | 118 |
Magnesium Therapy Prevents Senescence with the Reversal of Diabetes and Alzheimer’s Disease |
|
| Ian James Martins | | Health. 2016; 08(07): 694 | | [Pubmed] | [DOI] | | | 119 |
High absolute risk of severe infections among Indigenous adults in rural northern Australia is amplified by diabetes – A 7 year follow up study |
|
| Ming Li,Robyn McDermott | | Journal of Diabetes and its Complications. 2016; | | [Pubmed] | [DOI] | | | 120 |
Necrotizing Fasciitis in a 68-year old patient with Insulin-treated Steroid Diabetes |
|
| Christina Voulgari,Eleftheria Alexaki,Stavroula Chini,Sophia Vogiaki,Irene Gamatsi,Stamata Pagoni | | Journal of Clinical and Translational Endocrinology: Case Reports. 2016; | | [Pubmed] | [DOI] | | | 121 |
Comparison of a Simple Nutrition Screening Tool (SNST) Compared with Subjective Global Assessment (SGA) in Body Mass Index (BMI) Assessments of Type 2 Diabetic Patients Validation of SNST Versus BMI in T2 Diabetes |
|
| Banun B.R. Rohimah,S. Sugiarto,Ari A.P. Probandari,Budiyanti B.W. Wiboworini | | Pakistan Journal of Nutrition. 2016; 15(5): 412 | | [Pubmed] | [DOI] | | | 122 |
Topical Prostaglandin E Analog Restores Defective Dendritic Cell–Mediated Th17 Host Defense Against Methicillin-Resistant
Staphylococcus Aureus
in the Skin of Diabetic Mice |
|
| Naiara N. Dejani,Stephanie L. Brandt,Annie Piñeros,Nicole L. Glosson-Byers,Sue Wang,Young Min Son,Alexandra I. Medeiros,C. Henrique Serezani | | Diabetes. 2016; 65(12): 3718 | | [Pubmed] | [DOI] | | | 123 |
CLINICOPATHOLOGICAL STUDY OF DIABETIC FOOT ULCER - AN ACCOUNT OF ‘THE ROLE OF FOCUSED WOUND CARE’ AND ‘PRESSURE RELIEVING MEASURES’ IN HEALING |
|
| Amit Ray,Purba Haldar,Prakas Kumar Mandal,Indranil Chakraborty,Sushil Ranjan Ghoshal,Amitava Sarkar | | Journal of Evolution of Medical and Dental Sciences. 2016; 5(99): 7267 | | [Pubmed] | [DOI] | | | 124 |
Gangrenous Leg in a Patient With Diabetes on MDP Bone Scintigraphy |
|
| Osayande Evbuomwan,Olusegun Akinwale Ayeni,Shireen Dhoodhat,Mboyo Di Tamba Vangu | | Clinical Nuclear Medicine. 2016; 41(5): 428 | | [Pubmed] | [DOI] | | | 125 |
Hyperglycemia Impairs Neutrophil-Mediated Bacterial Clearance in Mice Infected with the Lyme Disease Pathogen |
|
| Ashkan Javid,Nataliya Zlotnikov,Helena Petrošová,Tian Tian Tang,Yang Zhang,Anil K. Bansal,Rhodaba Ebady,Maitry Parikh,Mijhgan Ahmed,Chunxiang Sun,Susan Newbigging,Yae Ram Kim,Marianna Santana Sosa,Michael Glogauer,Tara J. Moriarty,Brian Stevenson | | PLOS ONE. 2016; 11(6): e0158019 | | [Pubmed] | [DOI] | | | 126 |
The Skin Remodeling in Type 1 Diabetes and Insulin Resistance Animal Models |
|
| M. KNAS,K. WOLOSIK,A. ZALEWSKA,A. MIKUCKA-NICZYPORUK,I. KASACKA,M. NICZYPORUK | | Physiological Research. 2015; : 875 | | [Pubmed] | [DOI] | | | 127 |
Individuality, phenotypic differentiation, dormancy and ‘persistence’ in culturable bacterial systems: commonalities shared by environmental, laboratory, and clinical microbiology |
|
| Douglas Kell,Marnie Potgieter,Etheresia Pretorius | | F1000Research. 2015; 4: 179 | | [Pubmed] | [DOI] | | | 128 |
Individuality, phenotypic differentiation, dormancy and ‘persistence’ in culturable bacterial systems: commonalities shared by environmental, laboratory, and clinical microbiology |
|
| Douglas Kell,Marnie Potgieter,Etheresia Pretorius | | F1000Research. 2015; 4: 179 | | [Pubmed] | [DOI] | | | 129 |
Diabetes |
|
| Hagen Bomberg,Christine Kubulus,Franka List,Noemi Albert,Kathrin Schmitt,Stefan Gräber,Paul Kessler,Thorsten Steinfeldt,Thomas Standl,André Gottschalk,Stefan P. Wirtz,Gerald Burgard,Peter Geiger,Claudia D. Spies,Thomas Volk | | Regional Anesthesia and Pain Medicine. 2015; 40(1): 16 | | [Pubmed] | [DOI] | | | 130 |
Long-Term Immunogenicity and Safety of a Conventional Influenza Vaccine in Patients with Type 2 Diabetes |
|
| Yu Bin Seo,Ji Hyeon Baek,Jacob Lee,Joon Young Song,Jin Soo Lee,Hee Jin Cheong,Woo Joo Kim,S. A. Plotkin | | Clinical and Vaccine Immunology. 2015; 22(11): 1160 | | [Pubmed] | [DOI] | | | 131 |
Antibiotic Use Is Not a Risk Factor of Infection by Extended-Spectrum Beta-Lactamase Producing Bacteria in Dr. Soetomo Hospital Surabaya |
|
| NADHYA NUR FITRI,MUSOFA RUSLI,MANIK RETNO WAHYUNITISARI | | Microbiology Indonesia. 2015; 9(4): 150 | | [Pubmed] | [DOI] | | | 132 |
Neutralization of Mitochondrial Superoxide by Superoxide Dismutase 2 Promotes Bacterial Clearance and Regulates Phagocyte Numbers in Zebrafish |
|
| E. M. Peterman,C. Sullivan,M. F. Goody,I. Rodriguez-Nunez,J. A. Yoder,C. H. Kim,B. A. McCormick | | Infection and Immunity. 2015; 83(1): 430 | | [Pubmed] | [DOI] | | | 133 |
Discovery of novel 1,3,5-triazine-thiazolidine-2,4-diones as dipeptidyl peptidase-4 inhibitors with antibacterial activity targeting the S1 pocket for the treatment of type 2 diabetes |
|
| Jitendra Kumar Srivastava,Pragya Dubey,Saumya Singh,Hans Raj Bhat,Mukesh Kumar Kumawat,Udaya Pratap Singh | | RSC Adv.. 2015; 5(19): 14095 | | [Pubmed] | [DOI] | | | 134 |
Preliminary Phytochemical Screening and Biological Activities ofBulbine abyssinicaUsed in the Folk Medicine in the Eastern Cape Province, South Africa |
|
| Cromwell Mwiti Kibiti,Anthony Jide Afolayan | | Evidence-Based Complementary and Alternative Medicine. 2015; 2015: 1 | | [Pubmed] | [DOI] | | | 135 |
Leukotriene B4–mediated sterile inflammation promotes susceptibility to sepsis in a mouse model of type 1 diabetes |
|
| Luciano Ribeiro Filgueiras,Stephanie L. Brandt,Soujuan Wang,Zhuo Wang,David L. Morris,Carmella Evans-Molina,Raghavendra G. Mirmira,Sonia Jancar,C. Henrique Serezani | | Science Signaling. 2015; 8(361): ra10 | | [Pubmed] | [DOI] | | | 136 |
Temporal trends and factors associated with pediatric hospitalizations with respiratory infection |
|
| Yingxue Chen,Jianfang Liu,Elaine Larson | | Journal of Asthma. 2015; : 1 | | [Pubmed] | [DOI] | | | 137 |
Palliative Wound Care, Part 2 |
|
| Kevin R. Emmons,Barbara Dale,Cathy Crouch | | Home Healthcare Nurse. 2014; 32(4): 210 | | [Pubmed] | [DOI] | | | 138 |
Self-reported diabetes and mortality in a prospective Chinese elderly cohort study in Hong Kong |
|
| Chen Shen,C. Mary Schooling,Wai Man Chan,Siu Yin Lee,Gabriel M. Leung,Tai Hing Lam | | Preventive Medicine. 2014; | | [Pubmed] | [DOI] | | | 139 |
Neutrophil granulocyte functional status and expression of apoptosis markers in children with type 1 diabetes |
|
| Lyudmila Yuræevna Barycheva,Natalya Eduardovna Erdni-Goryaeva,Galina Alekseevna Alexandrovich | | Diabetes mellitus. 2014; 17(3): 77 | | [Pubmed] | [DOI] | | | 140 |
Complication Rates Following Elective Lumbar Fusion in Patients With Diabetes |
|
| Nicholas S. Golinvaux,Arya G. Varthi,Daniel D. Bohl,Bryce A. Basques,Jonathan N. Grauer | | Spine. 2014; 39(21): 1809 | | [Pubmed] | [DOI] | | | 141 |
Population-Based Cohort Study of Anti-Infective Medication Use before and after the Onset of Type 1 Diabetes in Children and Adolescents |
|
| Soulmaz Fazeli Farsani,Patrick C. Souverein,Marja M. J. van der Vorst,Catherijne A. J. Knibbe,Anthonius de Boer,Aukje K. Mantel-Teeuwisse | | Antimicrobial Agents and Chemotherapy. 2014; 58(8): 4666 | | [Pubmed] | [DOI] | | | 142 |
Disseminated Mucormycosis in an Adolescent with Newly Diagnosed Diabetes Mellitus |
|
| Michael C. McCrory,Blake A. Moore,Thomas A. Nakagawa,Laurence B. Givner,Donald R. Jason,Elizabeth L. Palavecino,Samuel J. Ajizian | | The Pediatric Infectious Disease Journal. 2014; 33(10): 1094 | | [Pubmed] | [DOI] | |
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