Diabetes and the Severity of Pandemic Influenza A (H1N1) Infection

[tetano]

Diabetes Care. 2010 Jul;33(7):1491-3.
Diabetes and the Severity of Pandemic Influenza A (H1N1) Infection.

Allard R, Leclerc P, Tremblay C, Tannenbaum TN.

Corresponding author: Robert Allard, rallard@santepub-mtl.qc.ca.
Abstract

OBJECTIVE To confirm the existence of an increased risk of complications from influenza A (H1N1)p among patients with diabetes. RESEARCH DESIGN AND METHODS Using data from an enhanced influenza surveillance project in Montreal, Canada, and age/sex-specific population estimates of diabetes prevalence, we estimated the risk of hospitalization among persons with diabetes. Comparing hospitalized patients admitted or not to an intensive care unit (ICU), we estimated the risk of ICU admission associated with diabetes, controlling for other patient characteristics. RESULTS Among 239 hospitalized patients with PCR-confirmed influenza A (H1N1)p, 162 (68%) were interviewed, of whom 22 had diabetes, when 7.1 were expected (prevalence ratio 3.10 [95% CI 2.04-4.71]). The odds ratio for ICU admission was 4.29 (95% CI 1.29-14.3) among hospitalized patients with diabetes compared to those without. CONCLUSIONS Diabetes triples the risk of hospitalization after influenza A (H1N1)p and quadruples the risk of ICU admission once hospitalized.

PMID: 20587722 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/20587722

 

[tetano]

Re: Diabetes and the Severity of Pandemic Influenza A (H1N1) Infection

MedWire News: Results from an influenza surveillance project in Canada show that patients with diabetes who become infected with the pandemic influenza A (H1N1) virus are at significantly greater risk for hospitalization and intensive care unit (ICU) admission than those without diabetes.

Diabetes is thought to be a risk factor for more severe flu infection, but attempts to quantify the increased risk have revealed differing results.

Robert Allard (University of Montreal) and colleagues studied 162 patients, aged an average of 28.6 years, who were hospitalized with polymerase chain reaction-confirmed pandemic H1N1 infection. Of these, 22 (14%) had diabetes, of whom nine had Type 1 and 13 had Type 2 diabetes.

The number of patients with diabetes was significantly higher than the 7.1 cases that would be expected from population rates, and the team found that the presence of either type of diabetes increased the risk for hospitalization with pandemic H1N1 infection around three fold compared with not having diabetes.

In addition, 32.3% (n=10) of the 31 patients with pandemic H1N1 infection who required admission to the ICU after hospital admission were diabetic.

The researchers calculated that diabetics had a significant 4.29-fold increased risk for ICU admission with pandemic H1N1 infection following adjustment for age and presence of cardiovascular disease, compared with nondiabetics.

The degree of risk was not significantly different between those with Type 1 and Type 2 diabetes.

The percentage of hospitalized patients with diabetes in this study was similar to that of previous studies in which 11-21% of hospitalized patients with pandemic H1N1 infection were reported to be diabetic.

"Our results corroborated the impression that persons with diabetes who contract pandemic H1N1 are more likely than others to be hospitalized or to require ICU care," add Allard and team in the journal Diabetes Care.

"As previously reported for infection-related mortality in diabetic patients, ICU risk was independent of the presence of coexisting heart disease."

The authors conclude: "Risk estimates for seasonal influenza could strengthen the basis for recommendations that persons with diabetes be regularly immunized against influenza."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. ? Springer Healthcare Ltd; 2010

http://www.medwire-news.md/48/88590...isk_factor_for_swine_flu_hospitalization.html