Brief Answer:
Pneumonia causes blood glucose level to rise and this leads to complication

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. Your patient has pneumonia involving right lung lower lobe segments. Infections cause blood glucose levels to rise to much higher levels initially. This is due to inflammation and bacterial proliferation.

2. Medical literature shows that FBS between 101-125 mg/dl (5.7-6.9 mmol/l) on hospital admission increases pneumonia complication rates among the elderly with no previous diagnosis of diabetes. Further increase in blood glucose might occur as severity of infection progresses.

3. Hyperglycemia during hospitalization in pneumonia patients, even in the non-diabetic range, may be a marker of immune dysfunction and/or a pro-inflammatory state and should aid in the identification of patients at higher risk for complication rates during hospitalization.

4. The patient had one of the known predictors of severe pneumonia and adverse complications. The reason for this is that at the molecular level, hyperglycemia affects pro-inflammatory cytokine production and the function of polymorphonuclear leukocytes and T cells. Alterations in polymorphonuclear cells have been extensively studied, with demonstration of defects in adhesion, chemotaxis, and phagocytosis when cells are exposed to hyperglycemia, supporting clinically observed adverse outcomes.

With treatment the blood glucose levels return to normal. However this takes longer in the elderly patients. A few patients might develop severe complications leading to death.

5. The increase WBC and neutrophils are due to activation of immune system.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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