Effect of Diabetes Mellitus on Sepsis Induced Multiple Organ Dysfunction Syndrome By Hayes Brown

Need Each year 500,000 people develop sepsis, with a survival rate of 29 percent Millions are spent on patient safety research 250,000 die each year in the United states Each year about 500,000 people develop sepsis, with a survival rate of 29 percent and 663 million dollars being spent for patient safety and research, 250,000 die each year in the United states. The main cause of death from sepsis is Multiple Organ Dysfunction Syndrome (MODS)

Knowledge Base When one develops a standard cut or bruise, every normal body would react with a cytokine response; this is the body’s standard immune response where white blood cells will be called to attack the foreign invader. In sepsis the body’s immune system will go into a sort of overdrive, producing an excessive amount of cytokines leading to over inflammation. The body’s inflammation can lead to thicker blood vessels, and this will lead to poor blood pressure. The inflammation can potentially become so horrendous that not enough blood and oxygen can get throughout the body, eventually leading to multiple organ dysfunction syndrome (MODS). Severe sepsis is one of the most common causes of death in the ICU. Sepsis triggers systemic inflammation and alterations in coagulation. The cellular and widespread endothelial damage that results leads to impaired tissue perfusion and altered circulation that affect the functioning of vital organs.

Cytokine

Diabetes Mellitus Death in women from diabetes It was found that of patients with a respiratory source of sepsis, 16% of those with DM developed acute respiratory failure compared with 23% in people without DM who developed the respiratory source of sepsis. patients with Diabetes Mellietus are less likely to develop respiratory failure during periods of sepsis, but more likely to develop acute renal failure. Dr. Martin believes that the reason for this could be impaired neutrophil function or altered neutrophil-endothelial interactions. Alternative reasons that those with DM are less likely to develop respiratory infection are because DM patients may be hospitalized earlier because they are aware more of specific signs of infection. Another explanation may be because medications administered to patients with DM, including insulin and thiazolidinediones, are known to have anti-inflammatory effects and lower blood glucose level. Previous studies reported that people with DM and severe sepsis are less likely to develop acute lung injury (ALI). We sought to determine whether organ dysfunction differed between people with and without DM and sepsis.

Type 1 and Type 2

DM and Sepsis

Knowledge Base Studies could help determine the relationship of DM and reduced risk of ALI Future studies should determine the relationship of these findings to reduced risk of ALI in people with DM and causative mechanisms. These findings can help decrease risk of acute lung injury in patients without DM

Suggested Reasons Hospitalized Earlier Red blood cell deformability increases risk of renal failure Diabetics more vulnerable to bacteremia

Literature Review Dr Tomsen (2008)-heightened risk of infections in diabetic people Dr. Reimar(2007)-patients with bacteremia caused by E. coli and related bacteria found about 17 percent had diabetes, compared with 6% without diabetes Dr. Friedman(2005)- DM patients have a greater risk of renal failure due to red blood cell deformibility

Literature Review Dr. Annette Esper (2006)-patients with Diabetes Mellitus less likely to develop respiratory failure during periods of sepsis, but more likely to develop infection of the urinary system Dr. Martin- those with (2006) DM less likely to develop respiratory infection because DM patients may be hospitalized earlier Dr. Annette Esper, and Greg Martin have found that patients with Diabetes Mellietus are less likely to develop respiratory failure during periods of sepsis, but more likely to develop acute renal failure Dr. Martin believes that the reason for this could be impaired neutrophil function or altered neutrophil-endothelial interactions. Alternative reasons that those with DM are less likely to develop respiratory infection are because DM patients may be hospitalized earlier because they are aware more of specific signs of infection. Another explanation may be because medications administered to patients with DM, including insulin and thiazolidinediones, are known to have anti-inflammatory effects and lower blood glucose level. red blood cell (RBC) deformability may be additively compromised in septic diabetic patients, leading to a further impairment of microcirculation.

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