Infections in children with diabetes

Luis Eduardo Calliari , Flávia J. Almeida , Renata Maria Noronha
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Abstract

Objective

The association between diabetes mellitus and infections is very common. These infections, even when mild, interfere with blood glucose control. The aim of this review is to describe infections that occur in children and adolescents with DM, as well as to provide recommendations on glycemia management during these episodes.

Source of data

A non‐systematic review was carried out in the PubMed database, using the terms “diabetes mellitus,” “infection,” “children,” and “adolescents.” The most relevant publications were selected.

Synthesis of data

In addition to the usual community diseases, some infections may occur predominantly in diabetic patients, especially when there is inadequate glycemic control, and common infections can be more severe in these patients. Alterations caused by the disease itself and the immune response are responsible for the risk of higher frequency and severity of infections. During infections, an increase in blood glucose occurs and usually an increase in insulin dose is required.

Conclusions

Pediatric patients with diabetes have some immune system disorders that, when associated with high glycemia, increase the risk of infections and their severity, and should be promptly identified and treated. The presence of an infectious condition, in turn, raises blood glucose and increases the risk of decompensation, and pediatricians should be cautioned to intensify monitoring and insulin therapy, and to avoid the risk of DKA. It should also be noted that many infections are preventable and can be avoided with adequate vaccine coverage.

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糖尿病儿童的感染
目的糖尿病与感染的关系是非常普遍的。这些感染,即使是轻微的,也会干扰血糖控制。本综述的目的是描述发生在儿童和青少年糖尿病患者中的感染,并在这些发作期间提供血糖管理建议。在PubMed数据库中使用“糖尿病”、“感染”、“儿童”和“青少年”等术语进行了非系统评价。选出了最相关的出版物。除了常见的社区疾病外,一些感染可能主要发生在糖尿病患者中,特别是在血糖控制不充分的情况下,这些患者的常见感染可能更严重。由疾病本身和免疫反应引起的改变是导致感染频率和严重程度更高的风险的原因。在感染期间,血糖升高,通常需要增加胰岛素剂量。结论儿科糖尿病患者存在一些免疫系统疾病,当伴有高血糖时,会增加感染的风险和严重程度,应及时发现和治疗。感染性疾病的存在,反过来又会升高血糖,增加代偿失调的风险,儿科医生应加强监测和胰岛素治疗,并避免DKA的风险。还应该指出,许多感染是可以预防的,并且可以通过充分的疫苗接种来避免。
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