Diabetes mellitus is a complex, chronic disease. By 2025, the disease will have affected a whopping 380 million people worldwide. Reduced immunity is one of the worst health challenges of diabetes. It makes diabetics vulnerable to a host of infections. Such infections include both common ones as well as those unique to diabetics.
An example is rhinocerebral mucormycosis, a type of fungal infection. Diabetics with uncontrolled sugar are at high risk of getting this infection. Those with diabetic ketoacidosis and hyperosmolar hyperglycemic state are particularly vulnerable. Nearly 70% of all reported cases of this fungus in the U.S. happen to diabetics.
Diabetes And Infections: What’s The Connection?
High blood sugar levels compromise how immune cells work. Our immune system produces special proteins called “antibodies.” These antibodies attach to bacterial cells that cause diseases. And they “mark” these cells for destruction by other cells of the immune system. When blood glucose levels are high, these antibodies get “glycated.” In other words, they are literally “stuck” to glucose molecules, making them ineffective.
Hyperglycemia also hampers the production of “cytokines.” Cytokines are the chemical messengers of the immune system. Cytokines play a vital role in communication between cells. This communication is crucial for fighting off infections quickly. High blood sugar also hampers other immune cells called “phagocytes,” which are responsible for destroying bacterial cells. High blood sugar also feeds viruses and bacteria, helping them multiply faster.
What Are the Common Infections Related to Diabetes?
Urinary Tract Infections (UTIs)
Diabetics are at a higher risk of serious infections in their upper urinary tract. These infections affect the kidneys, bladder or urethra. When you have UTI, your urine samples will show bacteria and pus in them. Bacterial pyelonephritis (inflammation of the kidneys due to a bacterial infection) is one such example. Fungi like Candida can also cause this inflammation.
Gastrointestinal and Liver Infections
Diabetics are also at a high risk of Helicobacter pylori These occur in the stomach and the digestive tract. H. pylori is known to cause several digestive problems, such as GERD and gastritis. If not treated on time, they can often lead to ulcers. There is enough data to suggest that once they develop, H. pylori isn’t easy to eliminate in diabetics. Chances of a reinfection are also higher in them as compared to non-diabetics.
Candida albicans causes oral and esophageal infections. Salmonella enteritidis and Campylobacter cause an inflammation of the gall bladder, called emphysematous cholecystitis. Diabetics are also more vulnerable to viral infections like Hepatitis C and Hepatitis B.
Skin and Soft Tissue Infections
Foot infections are among the most common health issues in diabetics. If untreated, they can lead to amputations, osteomyelitis (an inflammation of the bone caused by an infection) and even death. Infections of the foot fall in two categories: Moderate (“non-limb threatening”) and serious (“limb threatening”). Serious infections have deep ulcers and also affect bones or joints. Diabetic foot infections are caused either by a single organism (monomicrobial) or multiple organisms (polymicrobial). Commonly found microorganisms are Staphylococcus spp., Enterococci and streptococci.
Multiple bacteria may cause infection of the skin. They may also infect soft tissues of the chest, abdomen, extremities and groin. Areas affected by these infections typically display an ulcer that has dying skin cells. These areas also drain a colorless liquid with a very foul smell.
Diabetics are also vulnerable to a fasciitis (a type of inflammation) that affects the male genitalia. This inflammation is called “Fournier gangrene” and is caused by bacteria like Klebsiella spp., E. coli, etc.
Pneumonia is the most common respiratory infection among diabetics. Tuberculosis is another respiratory infection that is common in diabetics. People with diabetes are more susceptible against multi-drug resistant tuberculosis. Treatment failures and death is common in such people.
Head and Neck Infections
Invasive external otitis and rhinocerebral mucormycosis are two of the most serious infections affecting diabetics. Invasive external otitis affects the ear canal and can extend to the base of the skull. It is usually caused by a bacterium called Pseudomonas aeruginosa. The infection causes severe pain and loss of hearing. If the infection involves a nerve in the brain, it can also lead to facial paralysis.
Mucormycosis is a rare infection caused by fungi like Rhizopus, Mucor and Cunninghamella. It causes sinusitis, paralysis or opthalmoplegia. Opthalmoplegia is a weakness of the eye muscles that can lead to blindness. It can also lead to proptosis (protrusion of the eye ball).
Other infections with diabetes include periodontitis and the human immunodeficiency virus (HIV).
How Can Diabetics Avoid Infections?
High blood sugar levels are the real reason behind infections in diabetics. So work to reduce blood sugar levels. Take your medications (prescription or herbal) on time. More importantly, understand that Type 2 Diabetes is reversible – with the right mix of LCHF diet, intermittent fasting and exercise. Use dietary supplements to reduce stubborn blood sugar levels when needed.
Infections can be avoided by being very particular with personal hygiene. Most infections are caused by very common or opportunistic pathogens. Pathogens are bacteria and fungi already present on/within our body. However, they affect only when your immune defenses are down. Practicing regular personal hygiene can keep these organisms in check.
Foot injuries can be avoided by covering your feet with special socks and shoes. Foot care also involves avoiding bumps and scrapes. Regularly checking your feet for blisters, minor cuts and wounds can also help.
Keeping the immune system in overall good health is also important. You can try including dietary supplements that boost immunity in your daily dietary routine.
Remember: An early diagnosis is the key to treating infections before they cause further health issues. Diabetics should be extra-careful about early signs of infections, including:
- Fluctuations in blood sugar levels
- Foul-smelling vaginal discharge
- Burning sensation or pain while passing urine
- Cloudy or bloody urine (often with a foul smell)
- Difficulty in swallowing, throat pain
- Changes in bowel movements
- Pain in any part of the body
- Minor cuts, bruises and wounds, especially in the feet
You should immediately see your doctor if you experience any of these signs and symptoms.
Your doctor may ask you to undergo certain diagnostic tests to confirm the presence of an infection. If there is one, they will give you medication to help treat it. To get rid of infections, you need to follow the treatment regimen strictly to avoid further health issues.
The risk of infections is greater in diabetics. Diabetics are in a chronic state of low-grade inflammation. This, combined with oxidative stress and weak immunity, makes them more prone to infections. Diabetes makes everything harder to treat, so avoiding infections is the best solution.
There are several ways to catch infections in early stages. Practicing personal hygiene, boosting immunity, and regulating blood sugar levels are some time-tested techniques for preventing infections. Also, keeping an eye on subtle changes in body physiology helps too.