Abstract
Increase in the prevalence of diabetes worldwide and it becoming an epidemic has resulted in a clinical research shift to the management of diabetes mellitus globally. The study aimed to investigate the socio-demographic differences among diabetes patients with infection incidence. The study was conducted in an urban, governmental hospital in Penang Malaysia. The records of patients, more than and equal to age 18 years, who were admitted with diabetes mellitus between January 1, 2008 and December 31, 2010 were reviewed. Statistical analyses were performed using SPSS version 17®. This study was approved by the hospitals “Clinical Research Committee (CRC)” as well as “Ministry of Health Malaysia (MOH)”. During the time period of January 2008 through December 2010, there were total 2174 diabetes patients admitted; 2174 (100%) patients’ charts were reviewed. Of the total, 1063 (48.9%) were males and the rest, 1111 (51.1%), females. Mean and standard distribution (SD) showed females have less mean age distribution (35.2 ±4.187 years) as compared to males (37.9±5.724 years). A total of 798 (36.7%) had infection exposure before and/or during hospital admission; statistical significance (p<0.001) was found in association of diabetes ketoacidosis (DKA) and infection exposure. Though the rate of hospitalization increased among females, OR showed that males were more likely to get the infection severely as compared to females (1.81 (95%CI 1.1-2.40) p<0.021). Profound ethnic difference is three times more prone to severity rate of infection among Malay diabetic patients as compared to other non-Malays (OR 3.44 (95%CI 1.60-5.68)p<0.001). Further analysis showed that with the age of ≥ 65 years and history of diabetes (mean ± SD: 27.13 ± 2.782) average patient utilizes 135.7 days (average) of antibiotic course. Increased and recurrent use of antibiotic was found among Malays; also Malays predominantly experience clinical manifestations (poor glycaemic control) as compared to other ethnics. Every third patient with diabetes mellitus had infectious exposure. Key words: Diabetes mellitus, infections, factors association, clinical management, metabolic disorder, endocrinology.
Highlights
Increase trend in the prevalence of diabetes worldwide and it becoming an epidemic has caused a clinical research shift to the management of diabetes mellitus globally (King and Rewers, 1991; Bjork et al, 2003)
This study was approved by the hospitals “Clinical Research Committee (CRC)” as well as “Ministry of Health Malaysia (MOH)”
Increased and recurrent use of antibiotic was found among Malays; Malays predominantly experience clinical manifestations as compared to other ethnics
Summary
Increase trend in the prevalence of diabetes worldwide and it becoming an epidemic has caused a clinical research shift to the management of diabetes mellitus globally (King and Rewers, 1991; Bjork et al, 2003). About 285 million people are currently with diabetes worldwide, so increase in number is set to be about 438 million by the year 2030 (Sicree et al, 2009). This is more prevalent in developing countries of the world where the disorder predominantly affects. Half (46%) of all people with diabetes had at least 1 hospitalization or outpatient visit for infections compared with 38% of controls without diabetes (Shah and Hux, 2003). The risk ratio for diabetic vs non-diabetic persons was 1.21. The risk ratio for infectious diseaserelated hospitalization was up to 2.17, and was 1.92 for death attributable to infection. Some infections result in increased severity when they occur in diabetic patients and are associated with increased complications
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