Dengue infection has now assumed epidemic proportions in our country.dengue are caused by dengue virus. Dengue virus enters the human body through the bite of an aedes mosquito. The virus multiples and damages the blood, liver and causes dehydration, nausea and vomiting. Dengue infection can cause tremendous morbidity and can sometimes prove fatal. Diabetic patient contracting dengue are particularly at a higher risk of complications.
Any infection in the body causes a state of worsening insulin resistance. That is the insulin requirement of the body increases. This can lead to sudden increase in the blood sugars. However the person may be having nausea, vomiting and inability to eat. This can lead to hypoglycemia. Hence in the situation of an infection the sugars can fluctuate widely. It might become very low or very high. This may also lead to further dehydration, further lowering of immunity and secondary infections. This can complicate the patient. Also worsening of diabetes during dengue infection can lead to other complications like diabetic ketoacidosis or kidney failure.
Hence as soon as a diabetic get fever (any fever), he/she should more regularly monitor blood sugars. And consult his doctor. And in the event of sugars going high, dose adjustment has to be done by your doctor. Or insulin may have to be started temporarily. As the fever settles down the insulin resistance decreases and insulin requirements goes down. And patient may soon be able to go back to his previous diabetic medication doses. So it is very important that
1) Extra precaution should be taken during fever episode and more frequent blood sugar monitoring should be done
2) if required admit and start insulin therapy
3) Monitor blood sugars 2-3 times daily and control with appropriate doses of drugs or insulin.
4) Check for other complications like secondary infections,ketoacidosis or renal failure
5) Taper the doses as recovery takes place and patient is mobilized and starts eating adequately.
6) Consult doctor as soon as possible if you develop fever and if you are a diabetic.
Appropriate therapy and care of diabetes during Dengue infection goes a long way in preventing and minimizing mortality and morbidity.