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Can Sepsis Be Caused By Diabetes?

Increased Blood Glucose In Patients With Sepsis

Increased Blood Glucose In Patients With Sepsis

Summarized from Tiruvoipati R, Chiezey B, Lewis D et al. Stress hyperglycemia may not be harmful in critically ill patients with sepsis. J Critical Care 2012; 27:153-158 Frequent blood glucose measurement is one element of the routine intensive monitoring that all critically ill patients receive following admission to intensive care units. Transient increase in blood glucose concentration (hyperglycemia) is very common in this patient group. The significance of this so called stress hyperglycemia remains unclear. Some studies have demonstrated that normalisation of blood glucose with insulin therapy reduces mortality among the critically ill, implying that stress hyperglycemia is a harmful state that warrants treatment. Other studies suggest stress hyperglycemia is harmless, or even perhaps a beneficial compensatory response to critical illness. It seems increasingly likely that the significance depends not only on the severity of the hyperglycemia but also on the nature of the critical illness, and studies in this area are now focusing on specific patient groups within the community of the critically ill. A recently published retrospective study sought to determine the significance of stress hyperglycemia among patients admitted to intensive care with sepsis. The study population comprised 297 septic patients admitted to the intensive care unit of an Australian teaching hospital over a five year period. All patients had blood glucose concentration estimated at least once every six hours for the duration of their stay in intensive care. A blood gas analyzer sited in the unit was used for these measurements. Stress hyperglycemia was diagnosed if the mean of these blood glucose estimations exceeded 6.9 mmol/L. By this criterion 204 of the 297 (68.7 %) patients had stress Continue reading >>

Sepsis: Risk Factors, Symptoms, And Treatment

Sepsis: Risk Factors, Symptoms, And Treatment

Sepsis is the result of a massive immune response to bacterial infection that gets into the blood. It often leads to organ failure or injury. Sepsis is a medical emergency that becomes fatal or life-changing for many of the individuals who develop this "blood poisoning." Estimates for the number of people hospitalized in the United States for sepsis each year top 1 million and sepsis is in the top 10 of diseases leading to mortality in America. Here are some key points about sepsis. More detail and supporting information is in the main article. The symptoms of sepsis can be tricky to spot and may be mistaken for other serious illnesses Getting urgent medical treatment is key to the chances of surviving sepsis Sepsis is classed as a medical emergency. Sepsis is a specific condition in itself, but it is commonly caused by bacterial infection in the blood, which is called septicemia. This explains why the terms sepsis and septicemia are often used together. Poisons are released by the bacteria involved in septicemia The immune system mounts a massive inflammatory response to these poisons - this is referred to as sepsis The current definition of sepsis is based on relatively recent developments in the scientific understanding of the condition. The disease process is also not fully understood , with treatment still proving highly challenging. Sepsis is defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection." In lay terms, sepsis is a life-threatening condition that arises when the body's response to an infection injures its own tissues and organs. Sepsis is possible in anyone with an infection that develops a complication, but the people most at risk of sepsis are the very young and the old, and anyone with these risk factors : C Continue reading >>

Sepsis Or Septicemia (blood Infection) Symptoms, Causes, Treatments

Sepsis Or Septicemia (blood Infection) Symptoms, Causes, Treatments

Sepsis is caused by your bodys defense system ( immune system ) working overtime to fight infection. Its sometimes called septicemia. The large number of chemicals released into the blood during this process triggers widespread inflammation . This can lead to organ damage. Blood clotting during sepsis reduces blood flow to limbs and internal organs. This deprives them of nutrients and oxygen. In severe cases, one or more organs may fail. In the worst cases, sepsis leads to a life-threatening drop in blood pressure . Doctors call this septic shock . It can quickly lead to the failure of several organs -- lungs , kidneys , and liver . This can be fatal in some cases. Bacterial infections are most often to blame. But sepsis can also result from other infections. It can begin anywhere bacteria or viruses enter the body. So, it could sometimes be caused by something as minor as a scraped knee or nicked cuticle. If you have a more serious medical problem such as appendicitis , pneumonia , meningitis , or a urinary tract infection , youre also at risk. If you have an infection of the bone , called osteomyelitis , it could lead to sepsis. In people who are hospitalized, the bacteria that trigger sepsis can enter the body through IV lines, surgical incisions, urinary catheters, and bed sores. Anyone can get it, but certain groups of people are at greater risk. They include: People whose immune systems are not working well due to illnesses like HIV / AIDS or cancer People who take drugs that suppress the immune system , like steroids and those used to prevent rejection of transplanted organs The elderly, especially those with other health problems People who have recently been hospitalized and/or had major surgeries If you do have sepsis, your doctor will likely place you in the Continue reading >>

Infection As A Trigger Of Diabetic Ketoacidosis In Intensive Care—unit Patients

Infection As A Trigger Of Diabetic Ketoacidosis In Intensive Care—unit Patients

Together with hyperglycemic coma, diabetic ketoacidosis (DKA) is the most severe acute metabolic complication of diabetes mellitus [ 1 ]. Defined by the triad hyperglycemia, acidosis, and ketonuria, DKA can be inaugural or complicate known diabetes [ 2 ]. Although DKA is evidence of poor metabolic control and usually indicates an absolute or relative imbalance between the patient's requirements and the treatment, DKA-related mortality is low among patients who receive standardized treatment, which includes administration of insulin, correction of hydroelectrolytic disorders, and management of the triggering factor (which is often cessation of insulin therapy, an infection, or a myocardial infarction) [ 3–8 ]. Although there is no proof that diabetics are more susceptible to infection, they seem to have more difficulty handling infection once it occurs [ 9 , 10 ]. Indeed, several aspects of immunity are altered in diabetic patients: polymorphonuclear leukocyte function is depressed, particularly when acidosis is present, and leukocyte adherence, chemotaxis, phagocytosis, and bactericidal activity may also be impaired [ 11–15 ]. Joshi et al. [ 10 ] reported recently on the lack of clinical evidence that diabetics are more susceptible to infection than nondiabetic patients. Nevertheless, infection is a well-recognized trigger of DKA. Earlier studies have investigated the prevalence of infection as a trigger of DKA and the impact of antimicrobial treatment [ 2 , 15–18 ]. However, none of these studies were of intensive care unit (ICU) patients only. Furthermore, most were descriptive, included small numbers of patients, used univariate analysis only, and did not designate infection as the sole outcome variable of interest. Efforts to identify correlates of infection h Continue reading >>

Sepsis And Type Ii Diabetes Similarities

Sepsis And Type Ii Diabetes Similarities

Sepsis and Type 2 Diabetes: Cut From The Same Cloth? As we learn more and more about disease states, there tends to be more and more overlap between the pathology of acute inflammatory conditions and the pathology of 21st century chronic disease. At his SUNY New Paltz lecture in February, Robb introduced some correlations between Sepsis and Type 2 Diabetes Mellitus (T2DM). Many moons ago in graduate school, I had looked at both of these conditions separately, under a different guiding principle, so never put the two together, nor had research been done linking the two. Due to time constraints Robb was unable to get deep into the geek speak heart of the matter, however, the general conclusion he drew was that the etiology of both conditions, T2DM and Sepsis, are the same. In order to take a trip down memory lane back to my early 20s, I can now see the link between the two. Both sepsis and T2DM are a direct result of the bodys inflammatory response causing the bodys normal metabolic systems to go haywire. The key difference outside of main causality of each condition is the time course of the response. Sepsis is generally an acute condition which can quickly suck the life out of those inflicted. It is the most common cause of mortality in the non-coronary ICU, as the syndrome can progress to a graver condition, septic shock. Obesity, and the potential resulting T2DM, on the other hand are chronic conditions that suck the life out of society, as well as the individual, slowly. In both the diabetic and the septic patient, cardiovascular system dysfunction is the primary cause of morbidity. In both diseases, vascular damage of the endothelium in both small and large blood vessels lead to injuries to multiple organ and tissue structures. Obesity, and the T2DM which results f Continue reading >>

Diabetes And Sepsis: Risk, Recurrence, And Ruination

Diabetes And Sepsis: Risk, Recurrence, And Ruination

Diabetes and Sepsis: Risk, Recurrence, and Ruination 1Department of Surgery, Division of Acute Care Surgery, University of Michigan, Ann Arbor, MI, United States 2Department of Pathology, University of Michigan, Ann Arbor, MI, United States Edited by: Marc S. Horwitz, University of British Columbia, Canada Reviewed by: Todd M. Brusko, University of Florida, United States; Maria Bettini, Baylor College of Medicine, United States *Correspondence: Matthew J. Delano, [email protected] Specialty section: This article was submitted to Diabetes, a section of the journal Frontiers in Endocrinology Received 2017 Aug 7; Accepted 2017 Sep 27. Copyright 2017 Frydrych, Fattahi, He, Ward and Delano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. This article has been cited by other articles in PMC. Sepsis develops when an infection surpasses local tissue containment. A series of dysregulated physiological responses are generated, leading to organ dysfunction and a 10% mortality risk. When patients with sepsis demonstrate elevated serum lactates and require vasopressor therapy to maintain adequate blood pressure in the absence of hypovolemia, they are in septic shock with an in-hospital mortality rate >40%. With improvements in intensive care treatment strategies, overall sepsis mortality has diminished to ~20% at 30 days; however, mortality continues to steadily climb after recovery from the acute Continue reading >>

Diabetic Patients With Severe Sepsis Admitted To Intensive Care Unit Do Not Fare Worse Than Non-diabetic Patients: A Nationwide Population-based Cohort Study

Diabetic Patients With Severe Sepsis Admitted To Intensive Care Unit Do Not Fare Worse Than Non-diabetic Patients: A Nationwide Population-based Cohort Study

Abstract We sought to examine whether type 2 diabetes increases the risk of acute organ dysfunction and of hospital mortality following severe sepsis that requires admission to an intensive care unit (ICU). Nationwide population-based retrospective cohort study of 16,497 subjects with severe sepsis who had been admitted for the first time to an ICU during the period of 1998–2008. A diabetic cohort (n = 4573) and a non-diabetic cohort (n = 11924) were then created. Relative risk (RR) of organ dysfunctions, length of hospital stay (LOS), 90-days hospital mortality, ICU resource utilization and hazard ratio (HR) of mortality adjusted for age, gender, Charlson-Deyo comorbidity index score, surgical condition and number of acute organ dysfunction, were compared across patients with severe sepsis with or without diabetes. Results Diabetic patients with sepsis had a higher risk of developing acute kidney injury (RR, 1.54; 95% confidence interval (CI), 1.44–1.63) and were more likely to be undergoing hemodialysis (15.55% vs. 7.24%) in the ICU. However, the diabetic cohort had a lower risk of developing acute respiratory dysfunction (RR = 0.96, 0.94–0.97), hematological dysfunction (RR = 0.70, 0.56–0.89), and hepatic dysfunction (RR = 0.77, 0.63–0.93). In terms of adjusted HR for 90-days hospital mortality, the diabetic patients with severe sepsis did not fare significantly worse when afflicted with cardiovascular, respiratory, hepatic, renal and/or neurologic organ dysfunction and by numbers of organ dysfunction. There was no statistically significant difference in LOS between the two cohorts (median 17 vs. 16 days, interquartile range (IQR) 8–30 days, p = 0.11). Multiple logistic regression analysis to predict the occurrence of mortality shows that being diabetic w Continue reading >>

Diabetes Increases Risk Of Sepsis

Diabetes Increases Risk Of Sepsis

Home / Resources / Articles / Diabetes Increases Risk of Sepsis A new study adds potentially fatal blood infections to the list of health risks from diabetes. Sepsis, a condition that is on the rise in the United States as obesity rates climb, according to the Feb. 15 issue of Clinical Infectious Diseases. Researchers have known for years that obesity and diabetes are linked. Most diabetics have type 2 diabetesand most people with type 2 diabetes are obese. Diabetes can cause a host of health troubles, including kidney problems, damage to nerves and blood vessels and blindness. A heightened risk of infections in diabetic people has also been suggested. The condition known as sepsis can be brought on by bloodstream infection, and may lead to fever and septic shock, a potentially fatal drop in blood pressure. Diabetic people are more vulnerable to bacterial blood infections called bacteremia, particularly if they develop other bacterial infections, such as urinary tract infections (UTIs). Danish researchers studied more than 1,300 patients with bacteremia caused by E. coli and related bacteria and found that about 17 percent had diabetes, compared with only 6 percent among the controls, who were matched for age and sex from the general population. Compared with non-diabetics, diabetic patients were more likely to have bacteremia caused by urinary tract infection, rather than abdominal infection. Death after bacteremia also occurred more often in diabetics than in non-diabetics. So, with type 2 diabetes becoming increasingly common as Americans gain weight, the risk for serious infectious complications is a real one, according to Reimar Thomsen, M.D., Ph.D., lead author of the study. "Bacteremiais a life-threatening infection," he says, "and bacteremia with sepsis is the Continue reading >>

Infection In Patients With Diabetes Mellitus

Infection In Patients With Diabetes Mellitus

Infection in Patients With Diabetes Mellitus Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... Diabetes increases susceptibility to various types of infections. The most common sites of infection in diabetic patients are the skin and urinary tract. Malignant otitis externa and rhinocerebral mucormycosis are 2 head-and-neck infections seen almost exclusively in patients with diabetes. Malignant or necrotizing otitis externa principally occurs in diabetic patients older than 35 years and is almost always due to Pseudomonas aeruginosa. [ 1 ] Infection starts in the external auditory canal and spreads to adjacent soft tissue, cartilage, and bone. Patients typically present with severe ear pain and otorrhea. Rhinocerebral mucormycosis collectively refers to infections caused by various ubiquitous molds. [ 2 ] Invasive disease occurs in patients with poorly controlled diabetes, especially those with diabetic ketoacidosis. Organisms colonize the nose and paranasal sinuses, spreading to adjacent tissues by invading blood vessels and causing soft tissue necrosis and bony erosion. Patients with diabetes have an increased risk of asymptomatic bacteriuria and pyuria, cystitis, and, more important, serious upper urinary tract infection . [ 3 , 4 ] Intrarenal bacterial infection should be considered in the differential diagnosis of any patient with diabetes who presents with flank or abdominal pain. Pyelonephritis makes control of diabetes more difficult by causing insulin resistance; in addition, nausea may limit the patient's ability to maintain normal hydration. Treatment of pyelonephritis does not differ for patients with diabetes, but a lower threshold for hospital admission is appropriate. Sensory neuropathy, atherosclerotic vascular disease, Continue reading >>

Sepsis And Diabetes

Sepsis And Diabetes

Diabetes is a chronic (life-long) autoimmune disease that has a significant impact on your life. Having diabetes means you must work to control your blood glucose (sugar) levels to be sure that they don’t get too high or too low. The amount of glucose in your blood is important. Your body needs glucose for energy, but too much of it can destroy body tissues and too little can starve your body of nutrients. People who have diabetes are also at risk of developing wounds and sores that don’t heal well. While the wounds are present, they are at high risk of developing infection. And, again because of the diabetes, the infections can get severe quickly. When infection overwhelms the body, the body can respond by developing sepsis and going into septic shock. Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival. Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly) and/or amputations. What is diabetes? Your pancreas is a small organ (about 6” by 1.5”) that is part of your digestive system. It is connected to your small intestine and it lies just below your stomach towards the back. Your pancreas has a few roles, one is to help digest the food you eat and another is to secrete (send out) insulin, which stimulates your cells to use the glucose in the food and drink you consume. When a person has diabetes, the pancre Continue reading >>

What Infections Are You At Risk For With Diabetes?

What Infections Are You At Risk For With Diabetes?

What Infections Are You at Risk for With Diabetes? By Heather M. Ross | Reviewed by Richard N. Fogoros, MD People with diabetes are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defenses. In addition, some diabetes-related health issues, such as nerve damage and reduced blood flow to the extremities, increase the body's vulnerability to infection. What Kinds of Infections Are Most Likely If You Have Diabetes? When you have diabetes, you are especially prone to foot infections , yeast infections , urinary tract infections , and surgical site infections . In addition, yeast cells (Candida albicans) are more likely to colonize the mucous membranes (e.g., mouth, vagina, nose) in people with diabetes. These Candida cells then interfere with the normal infection-fighting action of white blood cells. With white blood cells impaired, Candida can replicate unchecked, causing yeast infections. High blood sugar levels contribute to this process. Other Sources of Diabetes-Related Infection Diabetic neuropathy ( nerve damage ) causes problems with sensation, particularly in the feet. This lack of sensation sometimes means foot injuries go unnoticed. Untreated injuries can lead to infection. Some types of neuropathy can also lead to dry, cracked skin, which allows a convenient entry point for infection into the body. People with diabetes often have low blood flow to the extremities. With less blood flow, the body is less able to mobilize normal immune defenses and nutrients that promote the body's ability to fight infection and promote healing. We know healthy eating is key to help manage diabetes, but that doesn't make it easy. Our free nutrition guide is here to help. Sign up and receive your free copy! Why Are Infecti Continue reading >>

Sepsis (blood Poisoning)

Sepsis (blood Poisoning)

Why are there so many diseases with "sepsis," "septic," "septicemia," or "blood poisoning" in their name? Sepsis (blood poisoning) facts Sepsis is a potentially life-threatening medical condition that's associated with an infection. Blood poisoning is a nonmedical term that usually refers to the medical condition known as sepsis. There are three described clinical stages of sepsis. The major diagnostic criteria for sepsis are altered mental status, increased respiratory rate, and low blood pressure. The majority of cases of sepsis are due to bacterial infection. Sepsis is treated with hospitalization, intravenous antibiotics, and therapy to support any organ dysfunction. Although the first health care professionals to treat a patient with sepsis may be a primary care, pediatric, or emergency-medicine specialist, critical care specialists, hospitalists, infectious disease, and lung (pulmonologists) specialists are usually consulted to help treat sepsis; infrequently, a toxicologist or surgeon may also be consulted. Prevention of infections and early diagnosis and treatment of sepsis are the best ways to prevent sepsis or reduce the problems sepsis causes. The prognosis depends on the severity of sepsis as well as the underlying health status of the patient; in general, the elderly have the worst prognosis. What Is a Staph Infection? Symptoms, Pictures The newest definition of sepsis has recently been published. In 2016, the Third International Consensus Definitions Task Force (Sepsis-3) defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to infection." The new criteria are based on just three symptoms: Patients who meet the above criteria likely have sepsis and are also termed septic. Blood tests are no longer required for the diagno Continue reading >>

Sepsis (septicemia) Symptoms, Contagious, Treatment & Signs

Sepsis (septicemia) Symptoms, Contagious, Treatment & Signs

Sepsis is a life-threatening condition in which the body is fighting a severe infection that has spread via the bloodstream. If a patient becomes "septic," they will likely have low blood pressure leading to poor circulation and lack of blood perfusion of vital tissues and organs. This condition is termed " shock " and is sometimes referred to as septic shock when an infection is the cause of shock to distinguish it from shock due to blood loss or from other causes. This condition can develop either as a result of the body's own defense system or from toxic substances made by the infecting agent. Survival rates for sepsis depend on the patient's underlying medical conditions, how quickly the diagnosis is made, the organism that causes the infection, and the patient's age. People whose immune systems (the body's defense against infections) are not functioning well because of an illness (such as diabetes or AIDS ) or because of medical treatments that weaken the immune system (such as chemotherapy for cancer or steroids for a number of medical conditions) are more prone to develop sepsis. It is important to remember that even healthy people can become septic. Very young babies , because their immune systems are not completely developed, may get sepsis if they become infected and are not treated in a timely manner. Often, if they develop signs of an infection such as fever , infants must receive antibiotics and be admitted to the hospital. Sepsis in the very young is often more difficult to diagnose because the typical signs of sepsis (fever, change in behavior) may not be present or may be more difficult to ascertain. The elderly population, especially those with other medical illnesses such as diabetes , may be at increased risk as well. Hospitalized patients are at ris Continue reading >>

The Link Between Staph Infection And Diabetes

The Link Between Staph Infection And Diabetes

Researchers have found that toxins in staph bacteria may be causing diabetes. While many people may not realize it, staph infection is a very real concern in the realm of wound healing. Staphylococcus bacteria often lives on the skin without causing any real harm to the body. However, when there is a puncture to the outer dermal layer, whether it’s broken skin from dryness or a full incision, the bacteria can enter the opening, causing a staph infection. If left untreated, it can lead to sepsis, which causes the blood pressure to drop drastically and can be fatal. Now, research has revealed a new concern regarding staph infection – one that affects not only wound healing, but also one’s quality of life. A study published in the journal for the American Society for Microbiology found that staph infection may be one of the causes of Type 2 diabetes. Staph and diabetes: exploring the relationship This study, conducted by microbiologists from the University of Iowa Carver College of Medicine, sought to explore the notion that bacterial exposure can affect a person’s chances of developing some chronic conditions. The researchers exposed rabbits to the same toxin, or superantigen, that is produced by Staphylococcus aureus. What they found was that, in high amounts, this toxin led to the development of symptoms associated with diabetes, including resistance to insulin and intolerance for glucose as well as inflammation. “We basically reproduced Type 2 diabetes in rabbits simply through chronic exposure to the staph superantigen,” said lead researcher Dr. Patrick Schlievert in a news release. To check these finding, the researchers then turned to human patients who already have diabetes. The scientists measured the amount of the staph bacteria and related toxins on Continue reading >>

Septic Shock: Symptoms, Causes, And Diagnosis

Septic Shock: Symptoms, Causes, And Diagnosis

Sepsis is the result of an infection, and causes drastic changes in the body. It can be very dangerous and potentially life-threatening. It occurs when chemicals that fight infection by triggering inflammatory reactions are released into the bloodstream. Doctors have identified three stages of sepsis: Sepsis is when the infection reaches the bloodstream and causes inflammation in the body. Severe sepsis is when the infection is severe enough to affect the function of your organs, such as the heart , brain , and kidneys . Septic shock is when you experience a significant drop in blood pressure that can lead to respiratory or heart failure , stroke , failure of other organs, and death. It is thought that the inflammation resulting from sepsis causes tiny blood clots to form. This can block oxygen and nutrients from reaching vital organs. The inflammation occurs most often in older adults or those with a weakened immune system. But both sepsis and septic shock can happen to anyone. Septic shock is the most common cause of death in intensive care units in the United States. The earlier sepsis is diagnosed and treated, the more likely you are to survive. Once sepsis is diagnosed, you will most likely be admitted to an Intensive Care Unit (ICU) for treatment. Doctors use a number of medications to treat septic shock, including: intravenous antibiotics to fight infection vasopressor medications, which are drugs that constrict blood vessels and help increase blood pressure Large amounts of intravenous (IV) fluids will be administered to treat dehydration and help increase blood pressure and blood flow to the organs. A respirator for breathing may also be necessary. Surgery may be performed to remove a source of infection, such as draining a pus-filled abscess or removing infec Continue reading >>

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