What Infections Are You at Risk for With Diabetes?

People with diabetes are more susceptible to developing infections, as high blood sugar levels can weaken the patient's immune system defenses. In addition, some diabetes-related health issues, such as nerve damage and reduced blood flow to the extremities, increase the body's vulnerability to infection.

What Kinds of Infections Are Most Likely If You Have Diabetes?

When you have diabetes, you are especially prone to foot infections, yeast infections, urinary tract infections, and surgical site infections.

In addition, yeast cells (Candida albicans) are more likely to colonize the mucous membranes (e.g., mouth, vagina, nose) in people with diabetes. These Candida cells then interfere with the normal infection-fighting action of white blood cells. With white blood cells impaired, Candida can replicate unchecked, causing yeast infections. High blood sugar levels contribute to this process.

Other Sources of Diabetes-Related Infection

Diabetic neuropathy (nerve damage) causes problems with sensation, particularly in the feet. This lack of sensation sometimes means foot injuries go unnoticed. Untreated injuries can lead to infection. Some types of neuropathy can also lead to dry, cracked skin, which allows a convenient entry point for infection into the body.

People with diabetes often have low blood flow to the extremities. With less blood flow, the body is less able to mobilize normal immune defenses and nutrients that promote the body's ability to fight infection and promote healing.

Why Are Infections Risky for People With Diabetes?

People with diabetes are more adversely affected when they get an infection than someone without the disease, because you have weakened immune defenses in diabetes. Studies have shown that even those who have minimally elevated blood sugar levels experience worse outcomes with infections.

Diabetic patients in hospitals do not necessarily have a higher mortality rate due to infections, but they do face longer hospitalization and recovery times.

What Can Be Done to Avoid Infections?

One of the most important things that you can do to avoid infections is to practice careful foot care. In addition to wearing shoes and socks to avoid minor bumps and scrapes, your feet should be examined daily for any blisters, cuts, scrapes, sores or other skin problems that could allow an infection to develop. Meticulous foot and skin care is needed to ensure that minor cuts and scrapes do not turn into ulcerated infections that can migrate to the bloodstream and cause major problems.

Good urinary hygiene, especially for women, can help minimize the possibility of developing urinary tract infections. This includes proper toilet hygiene, prompt urination after sexual intercourse, regular emptying of the bladder, and ample fluid intake.

Yeast infections can often be avoided by good vaginal care. This may include the avoidance of spermicides and douches. Eating foods with active cultures, such as yogurt containing acidophilus, can be helpful for preventing yeast infections.

Watch for Symptoms of Infection

Early diagnosis and prompt treatment of infections are important.

People with diabetes should be vigilant about paying attention to any changes in their bodies that could signal an infection.

Some examples of body changes that you should be alert to can include a rise in body temperature or change in blood sugars; foul-smelling vaginal discharge; pain with urination, or cloudy, bloody or foul-smelling urine; difficulty or painful swallowing; changes in bowel habits; and warmth or redness at any cut or scrape, including minor trauma locations and surgical sites. Any of these symptoms should be noted and mentioned to the patient's healthcare team.

Diagnosing and Treating Infections

Your health care provider may perform one or more tests to diagnose infection, including blood tests, microscopic examination of secretions, urine dipstick tests, x-rays and physical examination.

Healthcare providers may prescribe oral or topical antibiotics to treat some infections. Careful blood sugar control is important during any infection to promote healing and prevent further complications related to the infection.

Keep the following questions in mind when discussing any possible infections with your healthcare providers:

* For what symptoms should I call the doctor's office?
* How should I manage my medications (including oral and insulin) during an infection?
* Do antibiotics interact with any of my other medications?

_Sources:

_{Prevent Diabetes Problems: Keep Your Feet Healthy, National Institute of Diabetes and Digestive and Kidney Diseases, February 2014. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems.}

_{Juliana Casqueiro, Janine Casqueiro, and Cresio Alves "Infections in Patients With Diabetes Mellitus: A Review of Pathogenesis".Indian J Endocrinol Metab. 2012 Mar; 16(Suppl1): S27–S36. doi:  10.4103/2230-8210.94253 PMCID: PMC3354930.}

_{Amy C. Weintrob, et. al. "Susceptibility to Infections in Persons With Diabetes Mellitus." UpToDate. http://www.uptodate.com/contents/susceptibility-to-infections-in-persons-with-diabetes-mellitus.}