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Impact of glycemic control on coccidioidomycosis outcomes in patients with underlying diabetes mellitus in central California

Summary

This study examined how blood sugar control affects outcomes in patients with both diabetes and coccidioidomycosis, a fungal infection common in central California. Researchers found that patients with poorly controlled diabetes (higher HbA1c levels) had higher rates of serious lung disease with cavities and were less likely to recover from the infection. The study highlights that managing blood sugar levels may be just as important as taking antifungal medications when treating this dual condition.

Background

Diabetes mellitus is a known risk factor for severe coccidioidomycosis. Central California has high rates of both coccidioidomycosis and diabetes mellitus. The impact of glycemic control on coccidioidomycosis severity and outcomes in this population remains understudied.

Objective

To examine the impact of glycemic control on the severity and outcomes of coccidioidomycosis in patients with underlying diabetes mellitus in central California, an area endemic for the fungal infection.

Results

Higher HbA1c at coccidioidomycosis diagnosis was associated with increased odds of complicated pulmonary disease (OR=1.40) and cavitary disease (OR=1.43), but decreased odds of resolution (OR=0.66). Median HbA1c was 9% at diagnosis with IQR 7.5-11.6%. Sixty-four percent developed complicated pulmonary disease and 56% cavitary pulmonary disease. Only 28% achieved disease resolution with 10% mortality rate.

Conclusion

Poor glycemic control significantly impacts severity and resolution of coccidioidomycosis in diabetic patients. Achieving reasonable glycemic control and addressing barriers to effective diabetes management may be as crucial as antifungal therapy in this population.
  • Published in:Medical Mycology,
  • Study Type:Retrospective Cohort Study,
  • Source: PMID: 40246701, DOI: 10.1093/mmy/myaf039
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