Symptoms of infectious diseases in travellers with diabetes: A prospective study with matched controls
Baaten GGG., Roukens AHE., Geskus RB., Kint JAPCM., Coutinho RA., Sonder GJB., Van den Hoek JAR.
Background: Diabetic travellers to the (sub)tropics are thought to have symptomatic infectious diseases more often and longer than non-diabetics. Evidence for this is needed. This study evaluates whether diabetic travellers are at increased risk of symptomatic infectious diseases. Methods: A prospective study was performed between October 2003 and February 2008 among adult medication-dependent diabetic travellers, with their non-diabetic, non-immunesuppressed travel companions serving as matched controls. Thus, diabetics and controls were assumed to have comparable exposure to infection. Data on symptoms of infectious diseases were recorded by using a structured diary. Results: Among 70 insulin dependent diabetics, the incidence of travel-related diarrhea was 0.99 per person-month, and the median number of symptomatic days 1.54 per month. For their 70 controls, figures were 0.74, and 1.57, respectively (p>0.05). Among 82 non-insulin-dependent diabetics, incidence was 0.75, and the median number of symptomatic days was 1.68. For their 82 controls, figures were 0.70, and 1.68,respectively (p<0.05). As for other symptoms, no significant travel-related differences were found between diabetics and controls. Only 17% of diabetic travellers with diarrhea used their standby antibiotics. Conclusions: Medication-dependent diabetic travellers to (sub)tropical destinations do not have symptomatic infectious diseases more often or longer than non-diabetics. Although the incidence of metabolic dysregulation among diabetic travellers should be assessed in more detail, routine prescription of stand-by antibiotics against uncomplicated travellers' diarrhea is probably not useful, in particular not for NIDD. Self-treatment should be reserved for more complicated diarrhea. © 2010 The author and IOS Press. All rights reserved.