title: Relationship between Escherichia coli O157:H7 and diabetes mellitus.
abstract: Ingestion of Escherichia coli O157:H7 can cause a spectrum of acute illness, ranging from overt hemolytic-uremic syndrome (HUS), to gastroenteritis with bloody diarrhea, to no symptoms. This organism has been responsible for dozens of outbreaks of gastroenteritis and HUS in industrialized nations, and thus is a major public health concern. Although the acute effects of E. coli O157:H7 ingestion are well understood, the long-term complications are less well known. Here, we review the biological and empirical evidence supporting a link between E. coli O157:H7 and long-term diabetes mellitus. Survivors with diarrhea-associated HUS have a significantly increased incidence of diabetes due to complete insulin deficiency, which may recur several years after the initial infection. However, less severe forms of infection, such as E. coli O157:H7 gastroenteritis without overt HUS, do not appear to result in an increased risk of type 2 diabetes.
authors.affiliation: 1Division of Nephrology, Department of Medicine, University of Western Ontario, London, Ontario, Canada.
authors.forename: Rita S
authors.initials: RS
authors.lastname: Suri
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Mahon
authors.forename: William F
authors.initials: WF
authors.lastname: Clark
authors.forename: Louise M
authors.initials: LM
authors.lastname: Moist
authors.forename: Marina
authors.initials: M
authors.lastname: Salvadori
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D019453:Escherichia coli O157 / Q000302:isolation & purification* / Q000472:pathogenicity; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology*; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007223:Infant; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008372:Manure / Q000382:microbiology; D009864:Ontario / Q000453:epidemiology; D014871:Water Microbiology; D018508:Water Purification; D014881:Water Supply
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008372:Manure