More than 80 million people in India live with diabetes, and statistics say that more than 2 lakh people contract dengue every year1,2. Are you wondering why we are linking the two illnesses? Read on to know why.
It turns out that diabetes can worsen the complications caused by dengue, and now that winter is almost here, the dengue menace has shot up, too. If you are a diabetic, you should be extra cautious about mosquitoes this season, because dengue is more dangerous for you than for non-diabetics.
Dengue infection in patients with pre-existing diabetes is associated with significantly higher morbidity and mortality compared to non-diabetic individuals.
Evidence from Chennai shows that among dengue patients, approximately 30% had diabetes, and these patients were more likely to experience severe complications. Diabetic dengue patients frequently present with classical symptoms such as fever, vomiting, headache, muscle and body pain, but they are also prone to severe manifestations, including reduced urine output, bleeding tendencies, pedal oedema or ascites (swelling in feet or stomach), pleural effusion (fluid in lungs), and altered sensory stimulation. Blood abnormalities such as anaemia, thrombocytopenia, and leucocytosis (reduced red blood cells and platelets and increased white blood cells, respectively) are more pronounced in diabetic patients, contributing to worse outcomes3.
A prospective study further demonstrated that dengue-infected individuals with diabetes exhibit elevated inflammatory markers (CRP, Endocan, IL-8, and perfusion index). This indicated a heightened inflammatory response that can further increase blood sugar levels and the risk of severe dengue and bleeding disorders4.
It has been shown that in some diabetes patients, dengue caused very severe complications. They may suffer from respiratory problems, persistent vomiting, sore throat that makes swallowing difficult and continuous coughing. Also, intense abdominal pain, extremely high fever and splitting headaches may be higher in diabetics with increased chances of developing Dengue Haemorrhagic Fever (DHF). DHF is a more serious form of dengue, with bleeding tendencies, a low platelet count, and possible damage to the circulatory system5,6.
Blood glucose is an important factor for viral replication, and it basically facilitates virus transmission in mosquitoes, dengue causes fever and increases metabolic rate, which can lead to a rise in fluctuation in blood sugar levels, strict monitoring is very critical.
Dr Ashish Bajaj, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology
In cases of dengue in non-diabetics, patients may experience no symptoms, mild symptoms, or severe symptoms. These classical dengue symptoms may include headaches, rashes, low white blood cell levels, nausea, weakness and of course fever. As mentioned above, sometimes dengue may be very severe, increasing blood vessel wall permeability (bleeding tendency), causing the condition Dengue Haemorrhagic Fever (DHF). This condition is more common and likely to progress in diabetics6.
As this condition progresses, it may go on to something called Dengue Shock Syndrome. This is characterised by the same symptoms of internal haemorrhage, low pulse, change in mental state, and change in blood pressure that happen with DHF. Additionally, dengue shock syndrome results in multiple organ failures, failure in the circulatory system and a high risk of death7.
Overall, these findings show that diabetes significantly amplifies the severity and complications of dengue, underscoring the critical need for vigilant monitoring, prompt intervention, and individualised care in diabetic patients during dengue outbreaks.
Pathologically, dengue is characterised by high levels of inflammatory markers like CRP, endocan and IL-8. Thus, the dengue could be more fatal in patients that have co-morbid conditions of inflammation such as in diabetes.
Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)
There is not enough evidence that tell us why diabetes makes dengue more dangerous. But doctors believe that since a person with diabetes has weak immunity, fragile blood vessels, and a higher risk of haemorrhage, symptoms of dengue tend to worsen in diabetics7. Dengue destroys a person’s platelets, which may lead to blood clotting. Together, diabetes and dengue cause a lot of damage inside the body and make it difficult for the diabetic to recover6.
Winter, especially the beginning of winter, is when dengue incidents peak. Here are a few things that diabetics can do9:
Also Read: 5 Effective Preventive Measures for Dengue
If you have diabetes, you have to be extra careful about mosquitoes. Follow the precautions mentioned above to stay healthy and safe.
Diabetes greatly increases the risk of severe complications and poor outcomes in dengue. This makes early detection, close monitoring, and timely management especially vital for diabetics who get dengue symptoms. Although prompt identification and medical therapy are cornerstone of management, the importance of prevention cannot be overlooked especially during periods of outbreaks.
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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