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diabetes and infections

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Candidiasis of the skin

Ringworm on the scalp


Fungus nail infection

Diabetic foot ulcer

A person with diabetes mellitus is at higher risk for infections than other people.

What is going on in the body? 
Diabetes mellitus (DM) is a condition that affects the body's ability to regulate the level of sugar, or glucose in the blood. The result is a high level of glucose in the blood, known as hyperglycaemia. An increased level of glucose in the blood can cause a number of conditions. This, along with other factors, makes a person with DM more susceptible to infections. These infections may include:
  • foot and leg infections. These are due to poor circulation and nerve damage, known as diabetic neuropathy.
  • skin infections. These may include:
  • 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
What are the signs and symptoms of the condition? 
The signs and symptoms vary depending on the type of infection present. Skin infections may cause hot, red, swollen, or inflamed tissues. This 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: Also, an individual should report any other symptoms that seem unusual.

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 is 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.

What can be done to prevent the condition? 
There are a number of ways to prevent or decrease the risk of infection related to diabetes. The key is to control blood sugar through diet, exercise, and medications. Other factors that may decrease the risk of infections include:
  • daily foot care. This includes checking for open areas in the skin.
  • regular tooth brushing and dental visits
  • avoiding smoking. Smoking can worsen circulation problems.
  • regular immunisations against flu and pneumonia
How is the condition diagnosed? 
A doctor will take a medical history. He or she will also try to determine what may have led to the infection. Usually a physical examination will be done. Blood tests are often done to determine if there are bacteria in the blood, which may be causing the infection. If there is pus at a site of infection, it may be examined for bacteria to determine the cause of infection. In some cases, x-rays may be necessary to evaluate the extent of the infection.

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 associated with diabetes may be spread to others depending on the cause of the infection.

What are the treatments for the condition? 
A key element in treating infection is getting the person's blood glucose under control. Antibiotics are often used for treating bacterial infections. Anti-fungal medications 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 infections or bone infections, surgery may be necessary to remove the infected tissue.

What are the side effects of the treatments? 
Side effects vary depending on the treatment used. Antibiotics and anti-fungal medications can cause stomach upset and allergic reactions. Surgery poses a risk of bleeding, further infection, or allergic reaction to the anaesthesia.

What happens after treatment for the condition? 
Treatment will last a lifetime. DM cannot usually be cured but it can be controlled with careful management and treatment.

How is the condition monitored? 
Monitoring for infections related to DM is a life long process. A person who has DM will be advised to check his or her blood sugar daily. Blood tests, urine tests, foot and skin examinations, eye examinations, and visits with dieticians and other specialists are all part of routine monitoring and care for people with diabetes.

Reviewer: eknowhow Medical Review Panel
Editor: Dr JOhn Hearne
Last Updated: 28/02/2005
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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