Type 2 Diabetes Does Not Affect Pneumonia Incidence, Outcomes After Stroke

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Fasting plasma glucose levels on the second day of hospitalization were higher in patients who developed pneumonia.
Fasting plasma glucose levels on the second day of hospitalization were higher in patients who developed pneumonia.
The following article is part of conference coverage from the American Diabetes Association's 78th Scientific Sessions (ADA 2018) in Orlando,Florida. Endocrinology Advisor's staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back for the latest news from ADA 2018.

ORLANDO — In patients hospitalized with acute ischemic stroke, type 2 diabetes (T2D) is not associated with the incidence or outcome of pneumonia, according to results presented at the American Diabetes Association's 78th Scientific Sessions held in Orlando, Florida, June 22-26, 2018.

The prospective study included participants hospitalized with acute ischemic stroke (n=922). The researchers assessed the severity of stroke upon admission using the National Institutes of Health Stroke Scale (NIHSS). They assessed the outcome with dependency rates at discharge (modified Rankin scale 2 to 5) and in-hospital mortality.

During hospitalization, 113 participants developed pneumonia. Participants who developed pneumonia had higher fasting plasma glucose (FPG) levels at the 2nd day of hospitalization compared with participants who did not develop pneumonia (7.4±3.4 and 6.3±2.6 mmol/l, respectively; P <.005). However, the prevalence of T2D and glycated hemoglobin A1c (HbA1c) levels did not differ in the participants who did and did not develop pneumonia.

The results indicated that obesity (relative risk (RR) 2.05; 95% CI, 1.10-3.79; P <.05) and NIHSS at admission (RR 1.13, 95% CI, 1.09-1.16; P <.001) were independent risk factors for pneumonia.

In participants who developed pneumonia, 50.4% were dependent at discharge and 43.4% died during hospitalization. Patients who were dependent at discharge had similar rates of T2D, FPG, and HbA1c levels compared with participants who were independent at discharge.

Participants with pneumonia who died during hospitalization had higher FPG levels compared with participants who were discharged (8.3±4.4 and 6.7±2.3 mmol/l, respectively; P <.05). Rates of T2D and HbA1c levels did not differ between participants with pneumonia who died or were discharged. The researchers found that diastolic blood pressure at admission (RR 1.05; 95% CI, 1.01-1.09; P <.05) and NIHSS at admission (RR 1.16; 95% CI, 1.09-1.23; P<.001) were independent risk factors for in-hospital mortality.

Investigators concluded that “[T2d] does not appear to be associated with the incidence or the outcome of pneumonia in patients admitted with acute ischemic stroke.”

For more coverage of ADA 2018, click here. 

Reference

Papagianni M, Tziomalos K, Kostaki S, et al. Type 2 diabetes mellitus is not associated with the incidence or the outcome of pneumonia in patients with acute ischemic stroke. Presented at the ADA 2018 78th Scientific Sessions; June 22-26, 2018; Orlando, Florida. Poster 459.


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