Anyone can develop an infection, but if you have diabetes, you’re at an even greater risk.
While many infections are mild and easily treated, others are more severe and can lead to serious health issues.
So why is there a correlation between diabetes and infection risk?
Why Are People With Diabetes More Prone To Infection?
When you have diabetes, your immune system is likely altered. The exact reason isn’t entirely clear, but people with type 2 diabetes are generally thought to have an altered immune response, increasing the susceptibility to illness and infections.
Type 1 diabetes is an autoimmune condition where the immune system mistakenly attacks beta cells of the pancreas responsible for making insulin, so there is immune system involvement as well.
When your immune system can’t fight off things like bacteria, wounds are more likely to become infected. Infected wounds are more complicated and take longer to heal, and may lead to complications like amputations.
Having high blood glucose levels increases the likelihood of infections by providing more sugar to feed bacteria. High blood glucose translates into high blood sugar in the urine of diabetic patients, which can feed infections of the urinary tract system as well.
Uncontrolled diabetes impacts circulation, which is the process of your heart pumping oxygen-rich blood throughout your body. Having poor circulation means your body isn’t receiving as much oxygen- and nutrient-rich blood that’s needed to promote healing of infections.
What Infections Are You At Risk For With Diabetes?
Infections can be very common or more rare and serious. An infection happens whenever a pathogen like a virus or bacteria enters your body.
Infections can occur by breathing in droplets containing the pathogen (like the cold or flu), by touching an infected surface and then touching your eyes, nose, or mouth, or by allowing exposed skin (like a wound) to a pathogen. Skin can become infected from not cleaning it or keeping it properly covered.
Infections from bacteria can be treated using antibiotics, and fungal infections can be treated with antifungals. Infections from viruses aren’t as easily treated, such as the common cold virus.
Urinary tract infections
Urinary tract infections (UTIs) are more common in patients with diabetes. The extra sugar in the urine from high blood sugar levels feeds bacteria and can lead to infection.
Women are more likely to have a urinary tract infection than men because their urethra (the tube that carries urine from the bladder out of the body) is shorter than men’s, allowing bacteria to enter the bladder more easily.
If left untreated, a urinary tract infection can spread to your kidneys and become serious. Urinary tract infections are especially dangerous in pregnant diabetic patients, so prompt bladder infection treatment is necessary.
Some of the symptoms of a urinary tract infection include:
- A strong, persistent urge to urinate
- A burning sensation when urinating
- Passing small amounts of urine often
- Urine that appears cloudy
- Urine that appears red, bright pink, or cola-colored — a sign of blood in the urine
- Strong-smelling urine
- Pelvic pain in women — especially in the center of the pelvis and around the area of the pubic bone.
Excess sugar in the urine from high blood glucose can feed yeast and cause uncomfortable yeast infections. Yeast infections are more common among women with diabetes than those without diabetes since more sugar is in their urine.
Diabetic foot infections
Having extra sugar in your blood feeds bacteria that can infect wounds. High blood glucose levels can delay wound healing and increase the risk of wound infections.
The most common reasons for amputations in people with diabetes are poorly healing diabetic foot ulcers, which can spread to your leg. Diabetic foot ulcers can go unnoticed if you have neuropathy, so regular foot checks are important.
Diabetes increases the likelihood of being more severely impacted by common viruses like the flu.
The American Diabetes Association recommends that most people with type 1 diabetes and type 2 diabetes receive the flu vaccine each year to protect against severe illness from the flu.
Streptococcus pneumoniae is a type of bacteria that can cause pneumonia, an infection of the lungs that can cause trouble breathing, and complications among older people or those with respiratory issues.
Like the flu vaccine, it’s recommended that diabetic patients aged 65 and older receive the pneumonia vaccine to protect against severe complications from pneumonia.
Diabetic patients are at increased risk of developing ear infections. Infections from the bacteria Pseudomonas aeruginosa cause severe pain and can result in drainage from the affected ear(s).
Antibacterial ear drops are prescribed to treat painful ear infections, which can lead to hearing loss if severe and left untreated.
The most common type of fungus impacting diabetic patients is Candida albicans, the same kind of fungus that causes thrush. Diabetic patients can develop rashes from this yeast-like fungus anywhere on their skin.
The most common types of fungal infections impacting people with type 1 diabetes and type 2 diabetes are jock itch, athlete’s foot, yeast infections in women, and ringworm.
Rare but serious sinus infection
It’s a rarer infection, but having diabetes can increase your chance of developing a serious infection from Rhizopus oryzae in your nose and sinuses.
Infection from Rhizopus oryzae typically impacts diabetic patients with an altered immune system and is a complication of diabetic ketoacidosis.
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Symptoms Of Infection To Look Out For
One of the ways your body will alert you that there is a problem (such as infection) is through raised blood glucose levels. Illness and infection cause stress on your body, causing the release of stress hormones like cortisol and adrenaline.
These stress hormones cause elevated blood sugar levels and can be a cue that you’re fighting an infection.
Some of the general symptoms of skin infection to watch out for include:
- Leaking of pus or fluid
- Reddened skin around the injury
- A red streak that runs from the injury toward your heart
- A pimple or yellowish crust on top of the wound
- Sores that look like blisters
- Pain that gets worse after a few days
- Swelling that gets worse after a few days
- A fever
- A wound that hasn’t healed after ten days
Infections from a virus like the cold or flu have symptoms like:
- Sore throat
- Nasal congestion
- Runny nose
- Body aches
When To See A Doctor
You should seek medical attention if you have an infected wound since wound healing is delayed in patients with diabetes. Contact your healthcare provider if you have a deep wound, a wound that is oozing fluids, or a wound that is increasing in redness.
When in doubt, err on the side of caution and contact your healthcare provider, even with a call to the nurse’s triage line.
If you have type 1 diabetes, you need to watch for signs of diabetic ketoacidosis (DKA), a serious condition that can arise from being ill with an infection. Left untreated, DKA can be fatal, so it’s crucial to be aware of the symptoms and get prompt medical treatment.
You should seek immediate care if you have symptoms of DKA, including:
- Your blood sugar level is higher than your target range and isn’t responding to your regular treatment
- Blood glucose consistently higher than 300 mg/dL
- Moderate or high ketone presence in your urine
- Excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion
Respiratory infections like the common cold are usually mild. However, certain infections can spread to your lungs and cause pneumonia.
Signs of a serious respiratory infection that warrant medical treatment include:
- High fever that won’t go down with home treatment
- Difficulty breathing, including shortness of breath and/or wheezing
- Developing a bluish color in your lips and fingertips
- Chest pain
- Cough with mucus that is severe or is getting worse
How Can People With Diabetes Prevent Infections?
Having good glycemic control is the best way to reduce your risk of infections. If you have type 1 diabetes, that means taking your insulin as prescribed, whether through an insulin pump or insulin injections.
If you have type 2 diabetes, you can control your blood sugar levels through diet and/or medication, depending on your overall blood glucose control and how long you’ve had diabetes.
Some other ways people with type 1 diabetes and type 2 diabetes can help prevent infections:
Practice good skincare habits
Healthy skin is less likely to become damaged, which can increase the risk of a wound and infection setting in.
The American Diabetes Association recommends following good skin care habits such as:
- Keep your skin clean and dry.
- Avoid very hot baths and showers. And avoid bubble baths if your skin is dry – moisturizing soaps may help. Afterward, use a standard skin lotion, but don’t put creams between your toes which can cause too much moisture and fungal growth.
- Scratching dry or itchy skin can open it up and allow infection to set in. Prevent dry skin by moisturizing your skin, especially in cold or windy weather.
- Treat cuts right away by washing minor cuts with soap and water. Only use an antibiotic cream or ointment if your doctor says it’s okay, and cover minor cuts with sterile gauze. See your healthcare provider right away if you get a major cut, burn, or infection.
- During cold, dry months, keep your home more humid by running a humidifier. Bathe less during this weather, if possible, since bathing too often can dry your skin out.
- Use mild shampoos. High-sudsing shampoos can over-dry your skin.
- See a dermatologist (skin doctor) about skin problems if you cannot solve them yourself or with the help of your primary care provider.
Receive vaccines as recommended by your healthcare provider
It’s recommended that diabetic patients receive the flu vaccine every year. Your healthcare provider may also recommend you get the COVID-19 vaccine since people with diabetes are more likely to suffer more serious side effects from COVID-19.
Eat a healthy, well-balanced diet
Eating a diet rich in plant-based foods like fruits, vegetables, whole grains, nuts, seeds, healthy fats, and lean protein can help support healthy blood glucose levels. Avoid sugar-sweetened beverages and choose unsweetened drinks like water or tea.
Get regular physical activity
Moderate-intensity exercise can help improve your glycemic control. Exercise can even support your immune system as long as it’s not too vigorous in intensity or duration (like marathon training), which can be detrimental to your immune system.
There is a correlation between diabetes and infection risk. Promoting good glycemic control among patients with type 1 and type 2 diabetes is the best way to reduce the risk of developing infections.
Contact your healthcare provider for guidance if you think you have an infection. Early intervention is crucial for reducing side effects and complications.