Abstract
Objective1) To evaluate whether peripheral blood mononuclear cells (PBMCs) from type 2 diabetic patients present an impairment of phagocytic activity; 2) To determine whether the eventual impairment in phagocytic activity is related to glycemic control and can be reversed by improving blood glucose levels.Methods21 type 2 diabetic patients and 21 healthy volunteers were prospectively recruited for a case-control study. In addition, those patients in whom HbA1c was higher than 8% (n = 12) were hospitalized in order to complete a 5-day intensification treatment of blood glucose. Phagocytic activity was assessed by using a modified flow cytometry procedure developed in our laboratory based on DNA/RNA viable staining to discriminate erythrocytes and debris. This method is simple, highly sensitive and reproducible and it takes advantage of classic methods that are widely used in flow cytometry.ResultsType 2 diabetic patients showed a lower percentage of activated macrophages in comparison with non-diabetic subjects (54.00±18.93 vs 68.53±12.77%; p = 0.006) Significant negative correlations between phagocytic activity and fasting glucose (r = −0.619, p = 0.004) and HbA1c (r = −0.506, p = 0.019) were detected. In addition, multiple linear regression analyses showed that either fasting plasma glucose or HbA1c were independently associated with phagocytic activity. Furthermore, in the subset of patients who underwent metabolic optimization a significant increase in phagocytic activity was observed (p = 0.029).ConclusionsGlycemic control is related to phagocytic activity in type 2 diabetes. Our results suggest that improvement in phagocytic activity can be added to the beneficial effects of metabolic optimization.
Highlights
Patients with type 2 diabetes mellitus (T2DM) are immunocompromised and have an increased incidence of infections, mainly in the bone and skin, as well as in the respiratory, enteric and urinary tracts [1,2]
Case-control study The main clinical features of the study population are shown in Interventional study During the 5-day intensification treatment of blood glucose, a significant reduction in 9 point glycemic profile, fructosamine and HbA1c was achieved
In the present study we provide evidence that in T2DM patients the attenuated phagocytic activity of PMBCs exhibits a significant reversibility after glycemic control is improved
Summary
Patients with type 2 diabetes mellitus (T2DM) are immunocompromised and have an increased incidence of infections, mainly in the bone and skin, as well as in the respiratory, enteric and urinary tracts [1,2]. In a Canadian retrospective cohort study that included 513,749 people with T2DM matched to an equal number of nondiabetic subjects the risk ratio for infectious diseaserelated hospitalization was 2.17 (99% CI 2.10–2.23) for the diabetic population, and the risk ratio for death attributable to infection was up 1.92 (1.79–2.05) [2]. Diabetic foot ulcers are often complicated by infection and represent the first cause of nontraumatic amputations and are a leading cause of hospitalization among diabetic patients [3]. Infections can be considered as a complication of diabetes and significantly contribute to its associated economic burden
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
