A recent study has discovered that patients with advanced cirrhosis, uncontrolled diabetes mellitus (DM) seems to increase the risk of infections. Coupled with old age, the conditions also affect the survival outlook.
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Photo: Diabetes Mellitus in Elderly People | InStyleHealth |
Generating from the National Inpatient Sample of the USA,
the researchers identified 3,104,310 patients with advanced cirrhosis, of whom
29.2% were diagnosed with diabetes mellitus and subsequently covered in the current
study. The main result of interest was bacterial infection, while mortality
among the elderly was set as a secondary conclusion.
Collective data from 1998 to 2014 shows the prevalence
of DM increased from 21.3% to 38.4%. Meanwhile, the rate of uncontrolled DM
increased from 16.2% to 9.4% in 2004, prior rising slightly back to 13.2% by
2014; the annual percentage change of uncontrolled DM was -0.1%.
In general, 29.1% of participants had bacterial
infections, which was significantly prevalent among those with versus without
uncontrolled diabetes mellitus (DM), 34.2% vs 28.4%. There were multiple
infections occurred significantly more frequent among those with uncontrolled
DM, 9% vs 6.3% respectively.
Using the multivariable logistic regression analysis,
it was found out that uncontrolled DM increase the risk of bacterial infections
by more than 30%. While in a sub-analysis of 243,864 elderly patients, the
researchers discovered that while uncontrolled DM was rarer, 8.9% vs 13.3%, bacterial
infections were much more prevalent.
Unfortunately, combination of old age and uncontrolled
DM heightens the possibility of bacterial infections by over 40%, and of all-cause
mortality by more than 60%.
Source: Dig Liver Dis 2021;53:445-451