Table 1.
The role of diabetes in the severity of 2009 pandemic influenza.
| Year/s observed | Country | Sample size (% diabetes1) | Diabetes type2 | Primary outcome(s) measured | Results3 | Findings/conclusions | Reference |
|---|---|---|---|---|---|---|---|
| April 2009 – June | USA4 | 668 (2%) | n/a | Hospitalization | ND: 311/658 (47%), D: 5/10 (50%) | Diabetes did not affect the rate of | Garcia et al., 2015 |
| 2010 | ICU admission | ND: 114/658 (17%), D: 2/10 (20%) | hospitalization or ICU admission | ||||
| 1 January – 1 December 2009 | Spain | 11,499 (9%) | 97 Type I 936 Type II |
Death | ND: 244/10,416 (2%), D: 38/1,033 (4%) | No difference in fatality risk in any age group between those with and without diabetes | Jiménez-García et al., 2013 |
| 16 April – 30 August 2009 | Canada | 716 (7%) | n/a | Hospitalization ICU admission Death |
ND: 283/666 (43%), D: 38/50 (76%) ND: 39/666 (6%), D: 8/50 (16%) ND: 12/666 (2%), D: 3/50 (6%) |
Diabetes was associated with an increased risk of hospitalization. | Gilca et al., 2011 |
| 26 April – 26 | Canada | 1,479 (9%) | n/a | Non-severe outcome | ND: 1,089/1,342 (81%), D: 82/137 (60%) | The risk of a severe outcome was | Campbell et al., 2010 |
| September 2009 | Non-fatal ICU admission Death |
ND: 194/1,342 (15%), D: 42/137 (31%) ND: 59/1,342 (4%), D: 13/137 (10%) |
greatest among patients with diabetes |
||||
| 1 May – 31 December 2009 | USA | 66 (32%) | n/a | ICU admission | ND : 19/45 (42%), D: 10/21 (48%) | No difference in pre-existing comorbidities between ICU and non-ICU patients | Venkata et al., 2010 |
| 25 May – 1 July 2009 | Canada | 162 (13%) | 9 Type I 13 Type II |
ICU admission | ND: 21/140 (15%), D: 10/22 (45%) | Diabetes tripled the risk of hospitalization and quadrupled the risk of ICU admission once hospitalized | Allard et al., 2010 |
| 12 June – 5 December 2009 | Spain | 304 (50%) | n/a | ICU admission Death |
ND: 69/252 (27%), D: 97/252 (38%) ND: 15/252 (6%), D: 30/252 (12%) |
Worse outcomes in patients with diabetes may be a consequence of the higher prevalence of underlying medical conditions rather than diabetes itself | Cortes et al., 2011 |
| 24 July 2009 – 3 March 2010 | French West Indies and French Guiana | 241 (3%) | n/a | Severe infection Death |
ND: 27/234 (12%), D: 3/7 (43%) ND: 30/234 (13%), D: 0/7 (0%) |
Diabetes was associated with a higher risk of severe influenza | Barrau et al., 2012 |
| 1 October – 23 December 2009 | China | 155 (13%) | n/a | Death | ND: 20/128 (16%), D: 7/20 (35%) | Diabetes is likely to be an additional risk factor compared to obesity alone | Xi et al., 2010 |
| November 2009 – January 2010 | France | 1,266 (10%) | n/a | ICU admission Death |
Diabetes was a risk factor for ICU admission ND: 241/1139 (21%), D: 34/127 (27%) |
Diabetes is likely to be an additional risk factor compared to obesity alone for ICU admission but not death | Hanslik et al., 2010 |
| March – December 2010 | Brazil | 4,740 (2%) | n/a | Hospitalization | ND: 1,948/4,632 (42%), D: 72/108 (67%) | Diabetes was identified as a risk factor for hospitalization | Lenzi et al., 2012 |
1Percentage rounded to nearest whole number.
2n/a: Diabetes type was not specified.
3D: Patients with diabetes; ND: Patients without diabetes.
4Patients aged 18 years or younger.