A person with diabetes mellitus is at higher risk for infections than other people.
What is going on in the body?
Diabetes mellitus, also called DM, is a condition that makes it hard for the body to control the level of glucose in the blood. The result is a high level of glucose in the blood, known as hyperglycemia. An increased level of glucose in the blood can cause a number of problems. This, along with other factors, makes a person with DM more susceptible to infections. 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 Infection 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
What are the causes and risks of the condition?
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.
Symptoms & Signs
The signs and symptoms vary depending on the type of infection present. Skin infections may cause hot, red, swollen, or inflamed tissues. This is especially true in areas 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
- nausea and vomiting
Diagnosis & Tests
A doctor takes a medical history. He or she will also try to determine what may have led to the infection. Most often a physical exam will be done. 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.
Prevention & Expectations
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
- getting a vaccine for flu and pneumonia
What are the long-term effects of the condition?
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
What are the risks to others?
Infections linked with diabetes may be spread to others, depending on their cause.
Treatment & Monitoring
A key element in treating infection is getting the person’s blood glucose under control. 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.
What are the side effects of the treatments?
Antibiotics and antifungal medicines can cause stomach upset and allergic reactions. Surgery poses a risk of bleeding, further infection, or allergic reaction to anesthesia.
What happens after treatment for the condition?
Treatment of diabetes will last a lifetime. Diabetes cannot usually be cured, but it can be controlled with careful management and treatment.
How is the condition monitored?
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 doctor.
Revision date: June 14, 2011
Last revised: by Jorge P. Ribeiro, MD