Community acquired pneumonia is one of the leading infectious disease in developed nations and is a major cause of morbidity and mortality. Now, researchers have found that patients without pre-existing diabetes who have hyperglycemia on admission to hospital with community acquired pneumonia are at a significantly greater risk of death than patients with normal glucose levels on admission.

Findings from the study, published in British Medical Journal (BMJ), indicate that these patients may require intensified care in order to reduce their risk of death.

Although some studies state there is a link between hyperglycemia and mortality from pneumonia, results from other studies show no clear association.

In order to determine whether glucose levels (or pre-existing diabetes) predict adverse outcomes in patients admitted to hospital with community acquired pneumonia, a team of European researchers examined 6,891 patients admitted to hospitals and private practices with community acquired pneumonia between 2003 and 2009 in Germany, Austria, and Switzerland.

The researchers measured the severity of patients pneumonia using a standard test known as the CRB-65 score, and recorded information on their age, sex, co-morbidity, and current smoking status. Death at 28, 90 and 180 days was calculated according to blood sugar levels on admission to hospital.

In all patients, the team found that hyperglycemia was linked with increased mortality at 28 and 90 days. In addition, those with hyperglycemia on admission were considerably more likely to die than patients with normal sugar levels on admission. According to the researchers, the risk of mortality increased as admission glucose levels increased.

The team found that patients with diabetes had the highest mortality rate (14%) after 90 days regardless of their sugar levels on admission, patients without diabetes but with hyperglycemia on admission had a 10% mortality rate, and patients without diabetes and normal glucose levels had the lowest rate (3%).

The researchers explained: “Mortality starts to increase at only slightly elevated levels that remain below the defined threshold for overt diabetes.”

Furthermore, they note that glucose testing and monitoring after patients are discharged from the hospital are vital in order to diagnose diabetes and to prevent subsequent complications.

Written By Grace Rattue