Infections in Diabetes

Infections in Diabetes

One of the most common resaons of Diagnosis of Diabetes is infections of the uro-genital tract, like urine infections, infections of the skin of male organ or infections of the female organs. This itself outlines the importance of infectious diseases and the decreased immunity in uncontrolled Diabetes.

High blood sugar levels affect the cellular immunity of the body which is responsible for 'killing' the harmful pathogens. High glucose levels also form a fertile 'ground' for some deadly bacterias like Staphyloccocs to multiply and flourish.

Insulin has a very important role to play in the modulations of the immune system, its deficit reflects in the poor functioning of immune system in Diabetes and the fact that insulin treatment is absulutely essential in treatment of sever infections and sepsis together with potent antibiotics.

Diabetes and Infections

One on the common problems faced by Diabetics with high blood sugar levels are the common infections like, cold, influenza, sinusitis, Ear ache and discharge, pimples, abcesses, Gum infections and Urinary tract infections - which refuse to go.

 

Compromised immune system

Our body fights these infections through a variety of mechanisms, Either with help of speciallized cells which first of all 'recognize' then 'catch' these disease causing agents, subsequently some chemical reactions- complement cascade- take place which finally neutralize these infecting culprits.

With high blood sugar levels immune system is affected at all levels. Macrophages are not able to engulf 'catch' bacterias or viruses as they generally would, complement cascade also malfuntions so the bacterias or viruses even if 'caught' may not be neutralized.

Glucose itself is a rich medium which promotes the growth of bacterias and viruses, infact it is used in all laboratories as a culture medium to grow bacterias. High blood glucose levels make us prone to infections.

Our body is actively fighting against infections all the time, even when we may not have any obvious symptoms. Most of the infections are healed by the body itself without any medicines or other interventions. Most frequent and common are viral infections like influenza (flu, grippe or common cold), cuts and scratches. If the immune mechanisms mentioned earlier are impaired, healing is delayed, illness prolonged and more severe.

H1N1 influenza or the swine flu is just another example of influenza which may become severe in and uncontrolled Diabetic.

Fungal infections-

occur more frequently in diabetics. Fungus are ubiquitous organisms present everywhere and always, they only need fertile soil to grow. The only reason normal human beings are not affected by funguses is due to the active role of our immune system, whenever it is impaired, as happens in uncontrolled Diabetes- fungal infections causing itching, or sores develop, specially in moist areas like between toes and fingers.

Boils and pimples are also frequent in Diabetes-

reason again being the presence of causative microbes on the skin surface which are warded of by our immune system, but once it becomes weak as in uncontrolled Diabetes,

pathogens take over and run havoc with our skin.

Urinary tract infections-

which cause pain and burning while passing urine or frequent urges to pass urine is also very frequent in uncontrolled Diabetes.

Thus, there’s one more reason for controlling Diabetes -To stay healthy and quickly recover from unavoidable common infections.

 

Diabetic Foot is a complex condition of the foot caused due to many simultaneously occuring complications of Diabetes. It finally leads to formation of wounds or ulcers in the affected legs which may not heal quikcly or even require amputation of the affected part. The two important complications are Diabetic Neuropathy and Peripheral Vascular disease. Neuropathy affects the nerves carrying sensation of pain, touch and pressure from he feet to brain as well as supplying the blood vessels , increasing or decreasing blood flow in parts of the legs.Blood vessels may become constricted due to atherosclerosis and calcification leading to decreased blood flow to soles and other part of feet.

Role of microtrauma

Small or even microscopic trauma to the soles or even sometimes severe burns may go unnoticed by the patient whose nerves carrying sensation of pain have been damaged due to diabetes, unknowingly the damage persists and forms into a wound when it becomes visible.Healing of wounds require increased blood supply to the affected area to bring nutrients for repair of the damaged tissue. Clogged blood vessels of the legs are unable to cope up and such wounds do not heal easily, they get infected, if high blood sugar levels persist body is not able to fight off the bacterias and the infection may spread to bones as well, healing of such wounds may take months even in normal persons. Subsequently the tissue which is not getting sufficinet blood supply and has been infected Dies and ghas to be cut off this is called amputation.

Autonomic Neuropathy

In Charcots Foot' the nerves of Autonomic Nervous System are damaged- they unnecessarily increase the blood flow to lges leading to excessive dissolution of calcium from bones of the foot which makes them weak, such bones easily get deformed, fractured and infected, again leading to the same vicious cycle and amputations and deformity of the foot.

Footcare

Proper footcare is very essential for avoiding this devastating complication of Diabetes. Choice of footwear is very important, shoes should be comfortable without any areas of excessive pressure, insoles or custom made shoes should be used if theres any difficulty in finding adequate footwear.Feet should be inspected daily , if there are any cracks, wounds etc. they should be taken care of. A Diabetologist or foot specialist must inspect the feet and conduct testing to ascertain the status of nerves.

Treatment of Diabetic Foot

If foot infections do happen they require good nursing, cleaning and dressing- preferably done in clean settings by a professional, rest and antibiotics are also helpful. Non healing wounds may be helped by Hyperbaric Oxygenation, in which the affected part is kept under pressurised oxygen, this promotes healing. Laser therapy involving exposure of the affected wound to low power laser is also very effective.Blood Sugar should be strictly controlled in any infection.

 

Skin is the Largest organ affected by DiabetesSkin is the largest organ of our bodyand performs numerous important function. Skin itself is 'live' inside and keeps on growing and changing- eventhough the part which is visible to us comprises of the 'dead cells'. Due to many reasons Diabetes adversely affects this important part of our Body

1. Acanthosis Nigricans-May be one of the earliest signs of Insulinh resistance frequently seen in Type 2 Diabetics or prediabetics, causes darkening and thickening of skin at elbows,back of the neck, back of hand and some other places 

2. Abnormal Thickening of Skin of palms or fingers may even cause difficulty in their bending and require surgical procedures for release. 

3. Dryness of Skin- Soles and Heels are frequently excessively Dry and Cracked in Diabetics as a result of Autonomic Neuropathy which increases Blood Circulation and causes dryness due to decreased perspiration.

4.Hyperpigemntation-  Skin of legs and specially shin may become hyperpigmented with dark spots.

5. Lipoidica Diabeticorum is a rare Skin Complication in Diabetes , which affects the lower legs , causes a large ulcer which is very slow to heal with some oozing from the centre. It may take a long time to heal despite aggressive treatment.

6. Fungal & Bacterial infections of Skin are very common in uncontrolled Diabetes as the local immunity is impared due to high glucose levels.

 
Gum Disease

Gum infections and swelling, also called Gingivitis is a frequent but lesser known Chronic infection and swelling of Gumscomplication of uncontrolled Diabetes due to high Blood Glucose levels. Diabetics with gum disease suffer from frequent bleeding of gums, pain while chewing. Some studies have shown that such patients are more prone to Heart Diseases.

 These can be prevented and kept at bay only by Total control over Diabetes.

 

Urinary Problems

Women frequently suffer from Urinary Tract infections like cystitis ( Inflammation of the urinary Bladder ) which causes fever and or frequent urge to pass urine or Urethritis which causes burning sensation while passing urine.

Diabetics are more prone to infectins than the non diabetic population, this is due to the decreased immunity in Diabetics as a result of high blood sugar levels.

If the nerves controlling the relaxation and contraction of muscles of the urinary bladder get affected due to Diabetic Neuropathy, females Diabetics may suffer from difficulty in holding urine- causing involuantry passage of urine, as well as difficulty in passing urine.

One of the frequent complaints in Women with high blood sugar levels is Vaginal Discharge and itching, caused by fungal infections in Diabetics. This is also a major problem together with frequent urinary infections due to which women are diagnosed with Diabetes.

 
Complications of Ears

Ear problems in DiabeticsDiabetics are more prone to ear infections. The Ear infections in Diabetics are severe and difficult to treat. The Bacterias which frequently cause the infection of the middle and internal (Psedomonas Aeruginosa) ears may different from those in non Diabetics and are resistant to commonly used antibiotics for ears and thus may be difficult to treat.

Even common problems like upper respiratory tract infections ( Viral, cold or flu) may get complicated with unusual bacterias and are difficult to treat if blood sugar levels remain high. Diabetes affects the immune system and high blood glucose levels adversely affect our capability to fight infections.