ReviewTherapeutic advances in infectious disease
Diabetic immune dysfunction and severe influenza: A comprehensive narrative review with clinical implications.
Review in Therapeutic advances in infectious disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Diabetes mellitus is among the strongest independent risk factors for severe influenza, hospitalization, and influenza-associated acute respiratory distress syndrome (ARDS). The mechanistic basis of this association, and its clinical implications for immunomodulatory therapy, has been examined extensively in basic immunology and virology but is rarely synthesized for the practicing intensivist. This narrative review synthesizes the mechanistic basis by which diabetes predisposes to severe influenza and to translate the established pathogen-driven versus host-driven lung injury framework into a bedside-relevant heuristic for immunomodulatory decision-making. PubMed/MEDLINE and the Cochrane Library were searched from inception through April 2026, integrating evidence across innate and adaptive immunology, viral pathogenesis, and clinical trial data. The review was guided by the SANRA framework. Diabetes plausibly impairs early antiviral containment through disruption of type I interferon signaling, alveolar macrophage function, neutrophil-mediated barrier defense, and CD8
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