An analytical study of respiratory tract infections in diabetes mellites patients

Author(s): Ramu Kambley*

Introduction: Alternations in host defence mechanism in entire body as well as locally in lung, is the most important pathological factor in DM with lower respiratory tract infections (LRTI) patients. Studies and observations showing a high risk of infections in diabetics exist as this topic is still being debated upon. Impaired lung function and glucose intolerance, insulin resistance, type 2 diabetes and obesity have been proposed to be linked to each other. The current study was undertaken to determine the correlation between LRTI in patients with DM.

Methods: Total of 100 cases of DM with lower respiratory tract infections were analyzed in a period of 1 years to study the association between DM and lower respiratory tract infections. All 100 patients selected randomly from all ages and either sex admitted in local randomly selected Secondary and tertiary Care Hospitals (TB and chest ward) of our Block. The results obtained were analyzed in detail using statistical methods.

Results: The present study was carried out on 100 patients having DM with LRTI. The commonest age group affected was of 40-60 years (57%). Males were affected more than females with male: female ratio was 2.12. 38% patients were from urban area while 62% were from rural areas. 48% patients were from lower socioeconomic status, 34% from middle socioeconomic status and 18% from upper socioeconomic status. Cough and fever were most common symptoms. Besides that anorexia, weight loss, breathlessness, chest pain and haemoptysis were observed. Among all organisms causing LRTI, Mycobacterium tuberculosis was the most common organism isolated. Other organisms like Streptococcus pneumonia, Klebsiella pneumonia, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Influenza a (H1N1) were also isolated. No organism was isolated in 35% patients.

Conclusion: LRTI is common clinical illness among diabetic patients. DM patients with age more than 50 years, duration more than 4 years and uncontrolled DM status have higher chances of developing LRTI and other DM related complication. Mycobacterium tuberculosis is the most common isolated pathogen among DM with LRTI patients. Patients of DM with pulmonary TB have higher sputum positive grading. Radiologically, moderate to far advanced lesions with bilateral involvement were more common with predominant exudative or mixed variety. Study revealed that lack of education, poor life style, poor nutrition and absence of follow-up visits led to development of serious respiratory infections among diabetics. So there is a great need of health counseling regarding strict diabetic control and follow-up visits to improve their quality of life.