Diabetes Linked to Antimicrobial Resistance, New Study Finds

Anti-microbial resistance (AMR) is when microorganisms like bacteria, viruses, fungi, and parasites become resistant to medicines. World Health Organisation (WHO), estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths in the same year.

Overprescription of drugs is one of the leading causes behind this. Now, researchers have discovered that diabetics have a higher risk of developing AMR than normal people.

Researchers at the University of North Carolina School of Medicine discovered that diabetic mice with Staphylococcus aureus skin infections develop antibiotic resistance much faster than non-diabetic mice. Led by microbiologists Brian Conlon, PhD, and Lance Thurlow, PhD, the study found that high blood sugar levels create an environment where resistant mutations thrive. However, controlling blood sugar with insulin significantly reduced antibiotic resistance.

"We found that antibiotic resistance emerges much more rapidly in diabetic models than in non-diabetic ones. This could be a key factor in the rapid spread of antibiotic resistance," he said.

The study, published in Science Advances, highlights how diabetes weakens the immune system, allowing bacteria like S. aureus to multiply unchecked. Staph bacteria use glucose as fuel, and diabetes provides an abundance of it. As the infection grows, random mutations occur, some of which become resistant to antibiotics. Without a strong immune response to eliminate these resistant strains, they quickly take over.

Here's How The Study Was Conducted

To test this, researchers infected both diabetic and non-diabetic mice with S. aureus and treated them with the antibiotic rifampicin. In just four days, bacteria in diabetic mice became completely resistant, while no resistance appeared in non-diabetic mice. When the experiment was repeated with a small number of pre-resistant bacteria, these resistant strains quickly dominated the infection in diabetic mice but remained a minority in non-diabetic ones. The findings suggest that diabetes not only increases infection risk but also accelerates the development of antibiotic resistance, posing a global health threat. Since antibiotic-resistant bacteria can spread between people just like other germs, this could have widespread consequences.

Encouragingly, the study also showed that lowering blood sugar with insulin reduced the emergence of resistant bacteria. "When we gave diabetic mice insulin, their blood sugar levels improved, and we didn't see the rapid rise of resistant bacteria," said Conlon.

Antimicrobial Resistance

Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.

AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.

Antimicrobials - including antibiotics, antivirals, antifungals and antiparasitics - are medicines used to prevent and treat infections in humans, animals and plants. Microorganisms that develop antimicrobial resistance are sometimes referred to as "superbugs".

As antibiotic resistance increases, even common infections could become difficult to treat. For example, some doctors have already reported patients needing hospitalization for simple urinary tract infections. This rise in resistance could lead to more complications in hospitals, longer stays, and higher medical costs.

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