Infection, Diabetes and Septic Shock

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Sepsis should be one of the most feared diseases facing individuals with diabetes.  I’m not sure that it is, probably because it is generally not well understood and is not reported in the same dramatic manner as other illnesses.

However, those diagnosed with sepsis have up to a ~16% mortality rate.  This rises 40% for those with severe sepsis and to over 60% for those with septic shock.  Unlike cancer, which is significantly less deadly (see the figure), sepsis can strike in a matter of days and takes its toll on the young and old alike.  To make matters worse, there is apparently not a clear diagnostic criteria until the disease has progressed.  Until then, clinicians look for two or three indication that are often qualitative.  And, every hour that treatment is delayed carries a 7% increase in mortality.

What is sepsis?  It is the overwhelming response of the body to an infection.  It is the body’s deady response to infection or injury.

I once attended a talk in which the presenter described the body’s immune system as a booby-trap that is set to self-destruct when an intruder enters its premises.  The infection is the intruder and the response of the body’s immune system is what actually causes the deadly blast.

As I mentioned, sepsis is not diagnosed based on the location of infection or the type of pathogen.  Instead, clinicians look for indications such as low body temperature or fever, low blood pressure, high respiration rate, or abnormal white cell count.  Dizziness and confusion are top indicators of the onset of sepsis but are not the most specific criteria or easily observed.  Septic shock is diagnosed as sepsis with multi-organ dysfunction or failure.

And, is really does strike the old and the young as well as th rich as the poor.  It can follow a relatively minor abrasion or seemingly benign cut.  A tragic story was reported earlier this month:

A Blue Island teenager who died last week of a sepsis infection after root canal surgery was a victim of circumstances so rare that “it just doesn’t happen,” a dental expert said.

Christopher Reeve died of sepsis following an infected bedsore and if you follow the news you’ll see almost daily reports of unexpected deaths due to sepsis.

Unfortunately, uncontrolled diabetes tends to compromise the body’s ability to resist infection in a number of ways.  Elevated blood sugars through time compromises the immune system.  And, peripheral arterial disease and arteriosclerosis brings about susceptibility to foot ulcers and infections, bacterial blood infections, pneumonia, periodontal disease and others that can catalyze a septic response.

Having gotten to the end of this post I realize how bleak it is and I’m not a healthcare provider that can medical advice about what do.  However, there is value in awareness and I hope that this post will support you in that way.

 

Comments

  1. James says:

    Thanks for posting this. Are you currently connected to the Sepsis Alliance? If not, they would be glad to connect to you on this. I think there is a common cause here between SA and the diabetes community. Take care and thank you for your efforts!! jtp.

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