Volume 95, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The impact of chikungunya virus (CHIKV) infection on diabetic patients (DPs) has not been described. We aimed to compare clinical features of CHIKV infection in DPs and nondiabetic patients (NDPs), and to evaluate its effects on glycemic control among DPs. We recorded clinical information and, in DPs, glycemic control. Forty-six DPs and 53 NDPs aged ≥ 20 years living in Haiti, with acute CHIKV infection, were studied. Diabetes duration was 7.1 ± 6.1 years. The most common acute CHIKV clinical manifestations were arthralgia (100.0% DPs and 98.1% NDPs, = 1.000) and fever (86.9% DPs and 90.5% NDPs, = 0.750). In DPs as compared with NDPs, arthralgia was more intense (mean pain score of 6.0/10 ± 2.2 versus 5.1/10 ± 2.0, = 0.04) and took longer to improve (8.2 ± 3.0 versus 3.5 ± 2.5 days, < 0.0001). Severe arthralgia was more prevalent (58.7% versus 20.8%, = 0.0002), as was myalgia (80.4% versus 50.9%, = 0.003), and fever lasted longer (5.1 ± 1.8 versus 3.7 ± 1.7 days, = 0.0002). Among DPs, median fasting capillary glucose before versus after disease onset was 132.5 and 167.5 mg/dL ( < 0.001), corresponding to a median increase of 26.8% (interquartile range: 14.4–50.1%). Antidiabetic medication was titrated up in 41.3%. In summary, among DPs, CHIKV infection has a significant negative impact on glycemic control and, compared with NDPs, results in greater morbidity. Close clinical and glycemic observation is recommended in DPs with CHIKV infection.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Weaver SC, Lecuit M, , 2015. Chikungunya virus and the global spread of a mosquito-borne disease. N Engl J Med 372: 12311239.[Crossref] [Google Scholar]
  2. Staples JE, Breiman RF, Powers AM, , 2009. Chikungunya fever: an epidemiological review of a re-emerging infectious disease. Clin Infect Dis 49: 942948.[Crossref] [Google Scholar]
  3. Rajapakse S, Rodrigo C, Rajapakse A, , 2010. Atypical manifestations of chikungunya infection. Trans R Soc Trop Med Hyg 104: 8996.[Crossref] [Google Scholar]
  4. Economopoulou A, Dominguez M, Helynck B, Sissoko D, Wichmann O, Quenel P, Germonneau P, Quatresous I, , 2009. Atypical chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005–2006 outbreak on Réunion. Epidemiol Infect 137: 534541.[Crossref] [Google Scholar]
  5. Staples JE, Hills SL, Powers AM, , 2015. Chikungunya. CDC Yellow Book, Chapter 3. Infectious Diseases Related to Travel. Chikungunya. Available at: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/chikungunya. Accessed August 18, 2015. [Google Scholar]
  6. Leparc-Goffart I, Nougairede A, Cassadou S, Prat C, De Lamballerie X, , 2014. Chikungunya in the Americas. Lancet 383: 514.[Crossref] [Google Scholar]
  7. Pimentel R, Skewes-Ramm R, Moya J, , 2014. Chikungunya en la República Dominicana: lecciones aprendidas en los primeros seis meses. Rev Panam Salud Publica 36: 336341. [Google Scholar]
  8. Juste E St, , 2014. Le Chikungunya Est En Nette Régression, Selon Le MSPP. Le Nouvelliste (Port-au-Prince, Haiti), July 7, 2014. [Google Scholar]
  9. Tolokh I, Laux T, Kim D, , 2015. A case of diabetic ketoacidosis following chikungunya virus infection. Am J Trop Med Hyg 93: 401403.[Crossref] [Google Scholar]
  10. Borgherini G, Poubeau P, Staikowsky F, Lory M, Le Moullec N, Becquart JP, Wengling C, Michault A, Paganin F, , 2007. Outbreak of chikungunya on Reunion Island: early clinical and laboratory features in 157 adult patients. Clin Infect Dis 44: 14011407.[Crossref] [Google Scholar]
  11. American Diabetes Association, 2014. Classification and diagnosis of diabetes. Diabetes Care 38: S8S16. [Google Scholar]
  12. Htun NSN, Odermatt P, Eze IC, Boillat-Blanco N, D'Acremont V, Probst-Hensch N, , 2015. Is diabetes a risk factor for a severe clinical presentation of dengue?: review and meta-analysis. PLoS Negl Trop Dis 9: e0003741.[Crossref] [Google Scholar]
  13. Toledo J, George L, Martinez E, Lazaro A, Han WW, Coelho GE, Runge Ranzinger S, Horstick O, , 2016. Relevance of non-communicable comorbidities for the development of the severe forms of dengue: a systematic literature review. PLoS Negl Trop Dis 10: e0004284.[Crossref] [Google Scholar]
  14. Lindsey NP, Staples JE, Lehman JA, Fischer M, , 2012. Medical risk factors for severe West Nile Virus disease, United States, 2008–2010. Am J Trop Med Hyg 87: 179184.[Crossref] [Google Scholar]
  15. Couderc T, Chrétien F, Schilte C, Disson O, Brigitte M, Guivel-Benhassine F, Touret Y, Barau G, Cayet N, Schuffenecker I, Desprès P, Arenzana-Seisdedos F, Michault A, Albert ML, Lecuit M, , 2008. A mouse model for chikungunya: young age and inefficient type-I interferon signaling are risk factors for severe disease. PLoS Pathog 4: e29.[Crossref] [Google Scholar]
  16. Schilte C, Couderc T, Chretien F, Sourisseau M, Gangneux N, Guivel-Benhassine F, Kraxner A, Tschopp J, Higgs S, Michault A, Arenzana-Seisdedos F, Colonna M, Peduto L, Schwartz O, Lecuit M, Albert ML, , 2010. Type I IFN controls chikungunya virus via its action on nonhematopoietic cells. J Exp Med 207: 429442.[Crossref] [Google Scholar]
  17. Summers KL, Marleau AM, Mahon JL, McManus R, Hramiak I, Singh B, , 2006. Reduced IFN-alpha secretion by blood dendritic cells in human diabetes. Clin Immunol 121: 8189.[Crossref] [Google Scholar]
  18. Abraham R, Mudaliar P, Jaleel A, Srikanth J, Sreekumar E, , 2015. High throughput proteomic analysis and a comparative review identify the nuclear chaperone, nucleophosmin among the common set of proteins modulated in chikungunya virus infection. J Proteomics 120: 126141.[Crossref] [Google Scholar]
  19. World Health Organization, 2014. Malaria Rapid Diagnostic Test Performance. Summary Results of WHO Prouct Testing of Malaria RDTs: Round 1–5 (2008–2013). Geneva, Switzerland: World Health Organization. [Google Scholar]
  20. Existe A, Freeman N, Boncy J, Magloire R, Chang M, Bishop H, Macedo de Oliveira M, Dasilva A, Barnwell J, Slutsker L, Townes D, , 2010. Rapid diagnostic tests for malaria—Haiti, 2010. MMWR Morb Mortal Wkly Rep 59: 13721373. [Google Scholar]
  21. Blacksell SD, Jarman RG, Bailey MS, Tanganuchitcharnchai A, Jenjaroen K, Gibbons RV, Paris DH, Premaratna R, De Silva HJ, Lalloo DG, Day NPJ, , 2011. Evaluation of six commercial point-of-care tests for diagnosis of acute dengue infections: the need for combining NS1 antigen and IgM/IgG antibody detection to achieve acceptable levels of accuracy. Clin Vaccine Immunol 18: 20952101.[Crossref] [Google Scholar]
  22. Blacksell SD, , 2012. Commercial dengue rapid diagnostic tests for point-of-care application: recent evaluations and future needs? J Biomed Biotechnol 2012: 151967. [Google Scholar]
  23. Staikowsky F, Talarmin F, Grivard P, Souab A, Schuffenecker I, Le Roux K, Lecuit M, Michault A, , 2009. Prospective study of chikungunya virus acute infection in the Island of La Réunion during the 2005–2006 outbreak. PLoS One 4: e7603.[Crossref] [Google Scholar]
  24. Sa-Ngasang A, Anantapreecha S, A-Nuegoonpipat A, Chanama S, Wibulwattanakij S, Pattanakul K, Sawanpanyalert P, Kurane I, , 2006. Specific IgM and IgG responses in primary and secondary dengue virus infections determined by enzyme-linked immunosorbent assay. Epidemiol Infect 134: 820825.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 24 Apr 2016
  • Accepted : 06 Sep 2016
  • Published online : 07 Dec 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error