Sepsis in diabetes: A bad duo

Increasing incidence of morbidity and mortality of diabetic subjects due to infection necessitates the understanding of its patho-biology and further remedial measures for its prevention and treatment. The increased incidence of infection is because of systemic illness that has compromising effects on multiple organs including the nervous, vascular, musculoskeletal, and immunologic systems of the diabetic patients. Many factors contribute to this condition including hyperglycemia, insulin deficiency, ischemia and impaired immunity. Sepsis, as a separate entity, lead to destruction of cytokine network that can be fatal. Compromised defense mechanisms due to sepsis and cytokine dysregulation in diabetic patients make the situation worse. Early identification of local infection by applying advanced molecular tools, appropriate selection of antibiotics, intensive wound management, control of glycemic status and supportive treatment can reduce the rate of morbidity and mortality due to sepsis in patients with diabetes.

► Infection related morbidity and mortality is higher in diabetes.
► Significant factors are hyperglycemia, circulatory abnormality and poor immunity.
► Cytokine dysregulation plays vital role & therapy against this may be beneficial.
► Early and accurate diagnosis of infection help in proper antibiotic selection.
► Insulin infusion protocols with low chance of hypoglycemia are recommended.