Skip to main content
PMC home page
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1989 Nov;42(11):1143–1147. doi: 10.1136/jcp.42.11.1143

Changes in phagocytic function with glycaemic control in diabetic patients.

S M MacRury 1, C G Gemmell 1, K R Paterson 1, A C MacCuish 1
PMCID: PMC501970  PMID: 2584425

Abstract

Phagocytic function was assessed by serial whole blood chemiluminescence in poorly controlled type 2 (non-insulin dependent) diabetic patients during efforts to improve glycaemic control and compared with a group of well controlled type 1 (insulin dependent) diabetic patients. Chemiluminescence (corrected to a standard polymorphonuclear count) remained below normal (0.15-0.30 photons/second/cell) for most of the type 2 patients until 12 weeks when the value was significantly increased in patients showing improved glycaemic control (mean (range) 0.25 (0.01-0.43) photons/second/cell) compared with those showing no improvement (0.12(0.01-0.31) photons/second/cell). There was a significant inverse correlation of delta HbA1 with delta chemiluminescence. Although mean chemiluminescence for the type 1 diabetic patients was within the normal range, there was a wide scatter of values (0.19 (0.04-0.43) photons/second/cell) and there was no significant difference compared with the final value of type 2 patients with improved control. Glycaemic control is therefore a major determinant of phagocytic function in diabetic patients, but other factors must contribute, particularly in type 1 (insulin dependent) patients.

Full text

PDF
1144

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen B., Goldsmith G. H., Spagnuolo P. J. Neutrophil adhesive dysfunction in diabetes mellitus; the role of cellular and plasma factors. J Lab Clin Med. 1988 Mar;111(3):275–285. [PubMed] [Google Scholar]
  2. BYBEE J. D., ROGERS D. E. THE PHAGOCYTIC ACTIVITY OF POLYMORPHONUCLEAR LEUKOCYTES OBTAINED FROM PATIENTS WITH DIABETES MELLITUS. J Lab Clin Med. 1964 Jul;64:1–13. [PubMed] [Google Scholar]
  3. Babior B. M., Kipnes R. S., Curnutte J. T. Biological defense mechanisms. The production by leukocytes of superoxide, a potential bactericidal agent. J Clin Invest. 1973 Mar;52(3):741–744. doi: 10.1172/JCI107236. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bagdade J. D., Root R. K., Bulger R. J. Impaired leukocyte function in patients with poorly controlled diabetes. Diabetes. 1974 Jan;23(1):9–15. doi: 10.2337/diab.23.1.9. [DOI] [PubMed] [Google Scholar]
  5. Bagdade J. D., Stewart M., Walters E. Impaired granulocyte adherence. A reversible defect in host defense in patients with poorly controlled diabetes. Diabetes. 1978 Jun;27(6):677–681. doi: 10.2337/diab.27.6.677. [DOI] [PubMed] [Google Scholar]
  6. Davidson N. J., Sowden J. M., Fletcher J. Defective phagocytosis in insulin controlled diabetics: evidence for a reaction between glucose and opsonising proteins. J Clin Pathol. 1984 Jul;37(7):783–786. doi: 10.1136/jcp.37.7.783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dziatkowiak H., Kowalska M., Denys A. Phagocytic and bactericidal activity of granulocytes in diabetic children. Diabetes. 1982 Dec;31(12):1041–1043. doi: 10.2337/diacare.31.12.1041. [DOI] [PubMed] [Google Scholar]
  8. Gin H., Brottier E., Aubertin J. Influence of glycaemic normalisation by an artificial pancreas on phagocytic and bactericidal functions of granulocytes in insulin dependent diabetic patients. J Clin Pathol. 1984 Sep;37(9):1029–1031. doi: 10.1136/jcp.37.9.1029. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Goldstein I. M., Cerqueira M., Lind S., Kaplan H. B. Evidence that the superoxide-generating system of human leukocytes is associated with the cell surface. J Clin Invest. 1977 Feb;59(2):249–254. doi: 10.1172/JCI108635. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Mowat A., Baum J. Chemotaxis of polymorphonuclear leukocytes from patients with diabetes mellitus. N Engl J Med. 1971 Mar 25;284(12):621–627. doi: 10.1056/NEJM197103252841201. [DOI] [PubMed] [Google Scholar]
  11. Nolan C. M., Beaty H. N., Bagdade J. D. Further characterization of the impaired bactericidal function of granulocytes in patients with poorly controlled diabetes. Diabetes. 1978 Sep;27(9):889–894. doi: 10.2337/diab.27.9.889. [DOI] [PubMed] [Google Scholar]
  12. Pickering L. K., Cleary T. G., Getz S. Effect of glucose concentration and time on polymorphonuclear leukocyte function. J Clin Lab Immunol. 1982 May;8(1):31–35. [PubMed] [Google Scholar]
  13. Rayfield E. J., Ault M. J., Keusch G. T., Brothers M. J., Nechemias C., Smith H. Infection and diabetes: the case for glucose control. Am J Med. 1982 Mar;72(3):439–450. doi: 10.1016/0002-9343(82)90511-3. [DOI] [PubMed] [Google Scholar]
  14. Robertson H. D., Polk H. C., Jr The mechanism of infection in patients with diabetes mellitus: a review of leukocyte malfunction. Surgery. 1974 Jan;75(1):123–128. [PubMed] [Google Scholar]
  15. Shah S. V., Wallin J. D., Eilen S. D. Chemiluminescence and superoxide anion production by leukocytes from diabetic patients. J Clin Endocrinol Metab. 1983 Aug;57(2):402–409. doi: 10.1210/jcem-57-2-402. [DOI] [PubMed] [Google Scholar]
  16. Stjernholm R. L., Allen R. C., Steele R. H., Waring W. W., Harris J. A. Impaired chemiluminescence during phagocytosis of opsonized bacteria. Infect Immun. 1973 Feb;7(2):313–314. doi: 10.1128/iai.7.2.313-314.1973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Tan J. S., Anderson J. L., Watanakunakorn C., Phair J. P. Neutrophil dysfunction in diabetes mellitus. J Lab Clin Med. 1975 Jan;85(1):26–33. [PubMed] [Google Scholar]
  18. Tater D., Tepaut B., Bercovici J. P., Youinou P. Polymorphonuclear cell derangements in type I diabetes. Horm Metab Res. 1987 Dec;19(12):642–647. doi: 10.1055/s-2007-1011899. [DOI] [PubMed] [Google Scholar]
  19. Wheat L. J. Infection and diabetes mellitus. Diabetes Care. 1980 Jan-Feb;3(1):187–197. doi: 10.2337/diacare.3.1.187. [DOI] [PubMed] [Google Scholar]
  20. Wilson R. M., Reeves W. G. Neutrophil phagocytosis and killing in insulin-dependent diabetes. Clin Exp Immunol. 1986 Feb;63(2):478–484. [PMC free article] [PubMed] [Google Scholar]
  21. Wilson R. M., Tomlinson D. R., Reeves W. G. Neutrophil sorbitol production impairs oxidative killing in diabetes. Diabet Med. 1987 Jan-Feb;4(1):37–40. doi: 10.1111/j.1464-5491.1987.tb00825.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES