Neutrophil dysfunctions as a result of insulin and glucagon secretory abnormalities in diabetics with infection

ABSTRACT

The possible role of endocrine pancreatic function [insulin and glucagon] in the pathogenesis of neutrophil dysfunction in diabetics of both types [with or without infection] was the objective of this study. 40 diabetic patients, divided into 20 diabetics with infection [acute and chronic] and 20 diabetics without infection, were studied. Each group was equally subdivided into insulin dependent diabetes mellitus [IDDM], and non insulin dependent diabetes mellitus [NIDDM] groups. 22 subjects as a control group were divided into 12 healthy control and 10 controls with infection. Neutrophil functions [phagocytosis and peroxidase activities] and pancreatic endocrine hormones [insulin and glocagon] were assessed. There was a significant decrease [p < 0.01] in phagocytic activity and peroxides activity in both types of diabetes [with or without infection]. Infection was associated with a higher significant peroxidase stain score in both types of diabetes with a significant higher level in [NIDDM]. Postprandial blood glucose level was significantly [p < 0.01] inversely correlated with peroxidase value being more significant [p < 0.01] with infection but was not correlated with phagocytic function. Hyperglucagonemia [in both types of diabetics] and hyperinsulinemia in NIDDM, had a significant [p < 0.01] negative correlation with phagocytic activity but were not correlated with peroxidase value. These findings were more significant with infection. In conclusion, there is neutrophil dysfunctions in diabetics as indicated by the impairment of both phagocytic and peroxidase activities which is more profound with infection. Hyperglycemia exhibits a negative effect on bactericidal rather than phagocytosis, while the latter is influenced by the disturbed bihormonal profile [insulin and glucagon]