INFLUENCE OF DIABETES MELLITUS ON DISEASE OUTCOMES AND COMPLICATIONS IN DENGUE FEVER: A PROSPECTIVE OBSERVATIONAL STUDY.
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Keywords
Dengue; Diabetes mellitus; Severe dengue; Complications; Transfusion; ICU admission; Prognosis
Abstract
Diabetes mellitus is increasingly recognized as a host-level risk factor that may worsen the clinical trajectory of dengue infection by amplifying inflammatory and endothelial dysfunction, thereby predisposing to complications and severe disease.
Objectives: To compare disease outcomes, complication rates, transfusion requirements, and hospital stay between dengue patients with and without diabetes mellitus.
Methods: This prospective observational study included 100 serologically confirmed dengue patients admitted to a tertiary care center in Mumbai from June 2023 to June 2024. Patients were categorized into diabetic (n=25) and non-diabetic (n=75) groups. Clinical severity was classified according to the WHO 2009 criteria. Outcome variables included development of complications (shock, bleeding, fluid accumulation, hepatic/renal involvement), transfusion requirement, level of care (ward vs. HDU/ICU), duration of hospitalization, and final clinical outcome. Statistical significance was set at p < 0.05.
Results: Diabetic patients exhibited a higher proportion of warning signs (56.0% vs. 29.3%) and severe dengue (16.0% vs. 5.3%) than non-diabetics. Shock (12.0% vs. 2.7%) and hepatic involvement (40.0% vs. 24.0%) were more frequent in the diabetic subgroup. Transfusion requirement (32.0% vs. 9.3%) and HDU/ICU admission (20.0% vs. 4.0%) were also significantly higher among people with diabetes. Length of hospital stay was longer in diabetics (mean 5.8 vs. 4.6 days), and the only fatality occurred in this group.
Conclusion: Diabetes mellitus meaningfully worsened prognostic outcomes in dengue, as reflected by higher complication rates, greater need for escalated care, and prolonged hospitalization. These findings highlight diabetes as an early risk marker requiring intensified monitoring and proactive management to prevent deterioration.
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Dr Vaidya Chirayu Vijaykumar
Associate Professor, Department of General Medicine, Nootan Medical College & Research Center, Visnagar, Gujarat, India.
Dr Niyati Gosai
Associate Professor, Department of General Medicine, GMERS Medical College Gandhinagar, Gujarat, India
Dr Yashvi Luhar
Intern doctor, GMERS Medical College Gandhinagar, Gujarat, India
Dr Jainam Dilipbhai Shah
DNB Resident, Department of General Medicine, Khurshadji Behramji Bhabha Municipal General Hospital, Bandra West, Mumbai, Maharashtra, India