Type 2 diabetes may raise risk of severe dengue, warns review

People with Type 2 diabetes face a higher risk of severe, life-threatening dengue complications, according to a review paper slated for publication in the International Journal of Diabetes & Technology, which calls for integrating dengue vaccination into routine diabetes care to protect vulnerable populations in dengue-endemic regions better. The study authors note that persistently high blood sugar impairs immune function and damages blood vessels, which makes people with diabetes more susceptible to severe dengue infection. According to the authors, such patients are more likely to develop an exaggerated inflammatory response, or a “cytokine storm”, which can result in dengue haemorrhagic fever, internal bleeding and, in severe cases, dengue shock syndrome, a potentially fatal condition marked by a sharp fall in blood pressure. DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine. Diabetologist Dr Jothydev Kesavadev led the paper, which was co-authored by several leading diabetes experts from across the country, along with Dr Niti Pall, President-Elect of the International Diabetes Federation, Europe. "In India, there are more than 100 million people affected by diabetes. And among diabetics, there is a close to 2-4 times risk of developing heart attack, stroke, and multiple other infections and complications. Despite treatment, in 80-90 per cent of people, glucose remains high in our country. In our recommendation, we have mentioned that the dengue vaccine should be a part of routine care in diabetes," Dr Jothydev told indianexpress.com. Here's what you should note. Dr Rajiv Kovil, diabetes and obesity specialist at Zandra Healthcare, said that this is not a randomised trial but a review of existing evidence. "International observational studies and meta-analyses consistently suggest that people with diabetes who contract dengue have a higher likelihood of severe disease and possibly death. However, association does not prove causation, and the risk may also reflect age, obesity, kidney disease, hypertension or poor glycaemic control," said Dr Kovil. Symptoms to watch out for. The initial symptoms are similar for anyone with dengue and include high fever, severe body aches, headache, pain behind the eyes, nausea, and skin rash. "However, people with diabetes should be particularly aware if they experience persistent vomiting, severe abdominal pain, unusual drowsiness, bleeding from the gums or nose, reduced urine output, dizziness, or sudden weakness. They should also check their blood glucose more often because infections can cause unpredictable spikes or, in some cases, low sugar episodes due to poor food intake," said Dr Vijay Negalur, HoD diabetology, KIMS Hospitals, Thane. Hydration is crucial (Photo: Getty Images/Thinkstock) Prevention Prevention starts with avoiding mosquito bites by using repellents, wearing long-sleeved clothing, and getting rid of stagnant water around the home. Dr Negalur said that it is equally important to keep diabetes well-managed since stable blood sugar supports a stronger immune response. "Stay well-hydrated, eat balanced meals, and don’t ignore a fever that lasts more than a day or two. Anyone with diabetes who shows symptoms of dengue should seek medical advice early rather than wait for the illness to worsen," said Dr Negalur. "Vaccination recommendations must follow approved indications and national policy," added Dr Kovil. If someone with diabetes is diagnosed with dengue, are there any special treatment or monitoring considerations? Dr Negalur noted that some diabetes medications might need "temporary adjustments" based on the patient's condition, appetite, and hydration status. "Timely medical supervision and regular monitoring of platelet counts, blood glucose, and overall health can greatly lower the risk of serious complications and support a smoother recovery," said Dr Negalur. DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.