IS THERE A PREDISPOSITION TO INTESTINAL PARASITOSIS IN DIABETIC PATIENTS?
Eman E Taher and Mohamed M. El-Bahy*
Departments of Parasitology, Research Institute of Ophthalmology and Faculty of veterinary Medicine*, Cairo University
One hundred and fifty patients with uncontrolled diabetes (fasting blood sugar ranged between 189-280mg/dl) and 130 non-diabetic patients were randomly selected to evaluate the effect of diabetes as a predisposing factor increasing the susceptibility to enteric parasitic infections in Egypt; using both traditional and immuno-chromatographical techniques. Alteration in the total leucocytic count, eosinophils and neutrophils in each case was also evaluated. Moreover; 50 non-diabetic age matched volunteers were subjected to the same studies as control group. The present study revealed increase in susceptibility of diabetic patients to parasitic infections. High incidence was recorded in diabetics groups (18%-34.5%) in comparison with non- diabetic controls (6%-12.5 %).There was no privilege to certain parasitic type in relation to diabetes disease. In the same time the level of infection in each type was considered to be high in the diabetic group in comparison with non-diabetics especially in those associated with diarrhea. Infection by Entamoeba histolytica, and Giardia lamblia species was higher in diabetic group with diarrhea (20%, 14.5 %) respectively compared to diabetics with fever (15.55%, 11.11%) respectively. Infection rates of both parasites were higher in non-diabetic patients with diarrhea (10, 7.5%) compared to patients with diabetes only (6%). Cryptosporidium infection was higher in diabetic with fever patients (8.88%) compared to other groups. There was no significant difference (p≤0.05) in the percentage of infection by different parasites in different groups except that in diabetes with diarrhea and diabetes with fever groups. Moreover; high number of diagnostic stages per positive microscopic field was recorded mainly in the groups of diabetics in association with diarrhea or fever than in the group of diabetics or other symptom alone. There was significant increase in eosinophils and neutrophils in diabetics with diarrhea and fever in comparison with the control group. In conclusion: diabetes is considered to be an indirect cause leading to indirect increase in susceptibility to parasitic infections. This may be due to its variable depressant effects on the general immune system and health condition of the patients.