Diabetes And Infections

Diabetes mellitus (abbreviated as DM, but sometimes simply referred to as "diabetes"), is a condition that makes it hard for the body to move glucose, the main form of sugar in the body, from the blood into the cells. The resulting higher than normal level of glucose in the blood, known as hyperglycemia, can cause a number of symptoms and illnesses.

A person with DM is more susceptible to infections generally. These infections may include:

• foot and leg infections, including diabetic foot ulcers, which are caused by poor circulation and nerve damage, known as diabetic neuropathy
• vaginal yeast infections in women and jock itch in men
• ringworm and athlete's foot
• styes, which are infections of the eyelid
• boils, which are infections of the hair follicles
• carbuncles, which are infections of the tissue immediately under the skin
• nail infections
• urinary tract infections
• gum infections, known as gingivitis
• lung and sinus infections

The signs and symptoms vary depending on the type of infection present. Skin infections may cause hot, red, swollen, or inflamed tissues, especially where the skin is irritated or broken open. Gum infections may produce pain, swelling, and redness in the gum line. Urinary tract infections may cause cloudy or bloody urine or painful urination. Vaginal infections may cause itching, vaginal discharge, or pain.

Other signs of infection that should be reported to a doctor include:

• deep cough that produces phlegm
• difficulty breathing, or shortness of breath
• fever
• nausea and vomiting
• weakness

The causes of infections in a person with diabetes vary depending on the type of infection present. For example, nerve damage and poor circulation are seen in many people with diabetes. It may be hard for the person to notice cuts or breakdown of the skin on the feet. Feet can become infected without proper foot care.

There are a number of ways to prevent or decrease the risk of infection related to diabetes. The key is to control blood sugar levels through diet, exercise, and medicines. Other factors that may decrease the risk of infections include:

• daily foot care. This includes checking for open areas in the skin.
• regular toothbrushing and dental visits
• avoiding smoking, which can worsen circulation problems
• being vaccinated against influenza and pneumococcal pneumonia

A healthcare professional takes a medical history and performs a physical exam to determine what may have led to the infection. Blood tests are often done to see if there are bacteria in the blood that may be causing the infection. If there is pus at a site of infection, it may be examined for bacteria to determine its cause. In some cases, X-rays may be needed to assess the extent of the infection.

Long-term effects may include:

• kidney damage from frequent infections, leading to end-stage renal disease
• dental problems and gum disease, including gingivitis and periodontitis
• permanent skin damage
• amputation for progressive infection of the feet or legs

Infections linked with diabetes may be spread to others, depending on their cause.

A key element in treating infection is getting the person's blood sugar level under control with diet and medications sometimes including insulin. Antibiotics are often used for treating bacterial infections.

Antifungal medicines may be used for treating infections caused by a fungus. Topical antibiotic creams may be used for treating some mild skin infections. In cases of more severe skin or bone infections, surgery may be needed to remove the infected tissue.

Antibiotics and antifungal medicines can cause stomach upset and allergic reactions. Surgery can be complicated by bleeding, further infection, or an allergic reaction to anesthetic.

Treatment of diabetes will last a lifetime. Diabetes usually cannot be cured, but it can be controlled with careful management and treatment.

Monitoring for infections related to diabetes is a lifelong process. A person who has the disease will be advised to check his or her blood sugar daily. Blood tests, urine tests, foot and skin exams, eye exams, and visits with dietitians and other specialists are all part of routine monitoring and care for people with diabetes. Any new or worsening symptoms should be reported to the healthcare professional.