CLINICAL PROFILE AND PATTERN OF INFECTION AMONG DIABETIC PATIENTS IN A DIABETIC HOSPITAL, CHATTOGRAM

Abstract

Diabetes and prediabetes affect a substantial proportion of Bangladeshi people. To date, the economic burden and resource allocation for common diabetic complications like infection is not well defined in Bangladesh. Given the increasing prevalence of Diabetes mellitus in Bangladesh, there is a need to quantify the frequency in which diabetics seek care for infection and evaluate the associated clinical profile. This study aimed to investigate the clinical profile and pattern of infection among diabetic patients who attended a diabetic hospital in Chattogram, Bangladesh. This descriptive cross-sectional study included conveniently selected 206 known diabetic patients from the outpatient and inpatient Department of Diabetic Hospital, Chattogram, Bangladesh from May 2022 to 31st October 2022. Data regarding sociodemographic, behavioral, clinical features, biochemical parameters, and infections were collected using a structured case record form. Infections were identified by clinical examination and reviewing the medical records. Both descriptive and inferential statistics were used for the results. The sociodemographic features considered in this study were age, sex, education, monthly income and marital status which was 50.0±10.1 years, 53.9% were men, 34% completed SSC and most of the participants (86.4%) were married. 51.5% of the patients had a monthly income ≥ 30000 Taka. Diabetic patients with low level of education ‘P’value(0.002) and lower monthly income ‘P’ value(0.028) had more infection than those who had education above SSC and monthly income more than 30000Tk. Glycemic status was poor for 34.5%(7.4±3.9), 56.3%(9.8±2.7) and 46.6%(7.9±2.2) of the patients based on FBS, BS2hrsABF and HbA1c levels, respectively. Most of the patients, had eye complications (70.4%), followed by chronic kidney disease (20.4%), cardiovascular diseases (10.7%), neurological problems (2.9%). Fifty-seven (27.7%) patients had documented infection or evidence of infection on examination. The most common of them were UTI (33.3%), followed by pneumonia (24.6%), skin and soft tissue infections (14%), diabetic foot infection (8.8%). Other less frequently observed infections were fungal infections, tuberculosis, eye, ear, and bone infections. Significantly, higher proportion of patients with infections had poor glycemic status compared to the diabetic patients without infections (2HABF 73.7% versus 49.7%, HbA1c 61.4% versus 40.9%, P<0.05. One in four diabetes patients had evidence of infection, most commonly involving urinary and respiratory tracts. The results of this study can increase awareness of common infections associated with DM in a specialized hospital in Bangladesh.