Results from an influenza surveillance project in Canada show that patients with diabetes who become infected with the pandemic influenza A (H1N1) virus are at significantly greater risk for hospitalization and intensive care unit (ICU) admission than those without diabetes.

Diabetes is thought to be a risk factor for more severe flu infection, but attempts to quantify such increased risk have revealed differing results.

Robert Allard (University of Montreal) and colleagues reported outcomes of their study of 162 patients, aged 28.6 years on average, who were hospitalized with polymerase chain reaction-confirmed pandemic H1N1 infection. Of these, 22 (14%) had diabetes - nine had Type 1 and 13 had Type 2.

The number of patients with diabetes was significantly higher than the 7.1 cases that would be expected from population rates, and the team found that the presence of either type of diabetes increased the risk for hospitalization with pandemic H1N1 infection around three fold compared with not having diabetes.

In addition, 32.3% (n=10) of the 31 patients with pandemic H1N1 infection who required admission to the ICU after hospital admission were diabetic.

The researchers calculated that diabetics had a significant 4.29-fold increased risk for ICU admission with pandemic H1N1 infection following adjustment for age and presence of cardiovascular disease compared with nondiabetics. The degree of risk was not significantly different between those with Type 1 and Type 2 diabetes.

The percentage of hospitalized patients with diabetes in this study was similar to that of previous studies in which 11-21% of hospitalized patients with pandemic H1N1 infection were reported to be diabetic.

“Our results corroborated the impression that persons with diabetes who contract pandemic H1N1 are more likely than others to be hospitalized or to require ICU care,” add Allard and team in the journal Diabetes Care.

“As previously reported for infection-related mortality in diabetic patients, ICU risk was independent of the presence of coexisting heart disease.”

The authors conclude: “Risk estimates for seasonal influenza could strengthen the basis for recommendations that persons with diabetes be regularly immunized against influenza.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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