Prevalence of Sepsis Continuum in Patients With Type 2 Diabetes Mellitus at Tupua Tamasese Meaole Hospital in Samoa

Cureus. 2021 Sep 4;13(9):e17704. doi: 10.7759/cureus.17704. eCollection 2021 Sep.

Abstract

Background Individuals with longstanding type 2 diabetes mellitus (T2DM) have a significantly higher risk for infection caused by immune dysfunction, resulting in sepsis continuum (sepsis, severe sepsis, and septic shock) if not adequately addressed. In sepsis, organ dysfunction occurs because the host's response to infection is impaired, more so in severe sepsis. In septic shock, persistent hypotension happens, requiring vasopressors despite aggressive fluid management. The internal medicine (IM) ward plays a critical part in managing patients with sepsis. However, the prevalence of sepsis has been investigated extensively in an intensive care unit (ICU) setting instead of the IM ward. This study aimed to determine the prevalence rates of sepsis, severe sepsis, and septic shock in patients with T2DM admitted at an IM ward in Samoa. Methods This retrospective hospital record-based study was conducted over four months on 100 patients with T2DM admitted to the IM ward within the sepsis continuum. Participants were selected by convenience sampling, and the diagnosis was determined from the admission notes. Results The prevalence rates of sepsis, severe sepsis, and septic shock in patients with T2DM admitted to the IM ward were 80%, 12%, and 8%, respectively. Conclusion The most frequent presentation in individuals with T2DM who are within the sepsis continuum upon admission to the IM ward was sepsis, followed by severe sepsis and septic shock.

Keywords: diabetes; internal medicine; samoa; sepsis; traditional medicine.