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Why Are Diabetics At Higher Risk For Infection?

Complications Of Diabetes

Complications Of Diabetes

Complications are the negative effects of having a condition or illness, and there are a range of complications that may develop with diabetes. However it is important to remember that not everyone with diabetes will develop all or some of the complications. Understanding your diabetes and following the advice of your medical professional will lower your risk. Many of the complications of diabetes are much more likely to occur if you have high blood glucose levels or high blood pressure over long periods of time. Keeping both your blood glucose level and your blood pressure at a healthy range is your best defence against developing the complications of diabetes. Remember that every improvement you make to your blood glucose level or blood pressure will reduce your risk of developing complications. You don’t have to be in the target range to reduce your risks, although you will get the best improvement the closer your blood pressure and blood glucose are to target levels. It may seem daunting, but the good news is that there are things you can do to reduce your risk of developing complications, and if you have already developed a complication it’s likely there are things you can do manage it. On the side bar is more information on different complications and what you can do to stay well. For many years diabetes has been the leading cause of people developing blindness in New Zealand. However, with new advances in how to prevent or… Kidneys Having diabetes can damage the small blood vessels in your body. This is particularly so if your blood glucose levels or blood pressure remain high… Even common foot problems can be dangerous for people with diabetes, as they may lead to more serious foot problems. Impotence is a side effect of diabetes for many men. Impotence Continue reading >>

Surgical Site Infection Risk In Patients With Diabetes

Surgical Site Infection Risk In Patients With Diabetes

Surgical procedures are often unavoidable in patients with diabetes, and can even help reduce future risk of ulceration. But high postoperative infection rates in this patient population pose additional challenges to practitioners. by Ryan L. McMillen, DPM, Nicholas J. Lowery, DPM, and Dane K. Wukich, MD Diabetes mellitus (DM) is an increasing challenge for the medical community. It is estimated that 23.6 million people are afflicted in the United States, accounting for approximately 7.8% of the population.1 Nearly one third of persons with diabetes are unaware that they have DM. Often this disease is not diagnosed until patients present with complications of the disease. The incidence of DM has increased 30% over the past five years, and nearly 25% of the United States population over the age of 60 has DM.2 As the population continues to age, the prevalence will continue to rise. Alarmingly, DM is being diagnosed more frequently in younger patients.3 The rising prevalence of DM is a global problem, and it is estimated that there will be 366 million people with DM worldwide by the year 2030. The largest increases will occur in developing nations over that time span.4 Diabetes-related foot and ankle problems constitute a tremendous challenge for patients, caregivers, and the healthcare system, and the associated comorbidities should be considered a lifelong condition. Foot disorders in patients with diabetes, such as ulcers, infection, peripheral arterial disease (PAD) and Charcot neuroarthopathy (CN), are associated with severe morbidity and premature mortality, and they are a leading cause of hospital admissions in patients with DM.1,2 A higher incidence of DM occurs in non-Hispanic blacks, Native Americans, and persons of Hispanic and Latin heritage.5 Diabetes is asso Continue reading >>

Symptoms

Symptoms

Print Overview Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel. If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the causes may differ. Too much glucose can lead to serious health problems. Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered. Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe. Some of the signs and symptoms of type 1 and type 2 diabetes are: Increased thirst Frequent urination Extreme hunger Unexplained weight loss Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin) Fatigue Irritability Blurred vision Slow-healing sores Frequent infections, such as gums or skin infections and vaginal infections Although type 1 diabetes can develop at any age, it typically appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40. When to see a doctor If you suspect you or your child may have diabetes. If you notice any poss Continue reading >>

Type 2 Diabetes Mellitus And Increased Risk For Malaria Infection

Type 2 Diabetes Mellitus And Increased Risk For Malaria Infection

A case–control study of risk factors for type 2 diabetes and hypertension was conducted from August 2007 through June 2008 at Komfo-Anokye Teaching Hospital, Kumasi, Ghana. The patients’ clinical and biochemical signs and symptoms were secondary objectives (I. Danquah et al., unpub. data). The study protocol was approved by the Ethics Committee, University of Science and Technology, Kumasi, and participants gave informed written consent. Patients attending the diabetes (n = 495) or hypertension center (n = 451) were recruited. These patients promoted participation as preliminary (i.e., to be confirmed) controls to community members, neighbors, and friends (n = 222). Further preliminary controls were recruited from the outpatient department (n = 150) and among hospital staff (n = 148). Participants were told to fast, abstain from alcohol and nicotine use, and avoid stressful and physical activities beginning at 10pm the day before examination. On the day of examination, participants were asked about medical history and socioeconomic background, underwent physical examination, and provided venous blood and urine samples for laboratory testing. Fasting plasma glucose (hereafter referred to as glucose concentration; fluoride plasma 4°C) and hemoglobin (Hb) concentrations were measured (Glucose-201+, B-Hemoglobin; HemoCue, Angelhom, Sweden). Irrespective of symptoms, malaria parasites were counted per 500 leukocytes on Giemsa-stained thick blood films. Plasmodium infection and species were ascertained by PCR that included positive and negative controls (7). Patients with type 2 diabetes mellitus were defined as those receiving documented treatment with antidiabetes medication or having a glucose concentration >7 mmol/L (8); patients with hypertension were defined as tho Continue reading >>

Infection In Patients With Diabetes Mellitus

Infection In Patients With Diabetes Mellitus

Practice Essentials Diabetes increases susceptibility to various types of infections. The most common sites of infection in diabetic patients are the skin and urinary tract. Ear, Nose, and Throat Infections Malignant otitis externa and rhinocerebral mucormycosis are 2 head-and-neck infections seen almost exclusively in patients with diabetes. Malignant or necrotizing otitis externa principally occurs in diabetic patients older than 35 years and is almost always due to Pseudomonas aeruginosa. [1] Infection starts in the external auditory canal and spreads to adjacent soft tissue, cartilage, and bone. Patients typically present with severe ear pain and otorrhea. Rhinocerebral mucormycosis collectively refers to infections caused by various ubiquitous molds. [2] Invasive disease occurs in patients with poorly controlled diabetes, especially those with diabetic ketoacidosis. Organisms colonize the nose and paranasal sinuses, spreading to adjacent tissues by invading blood vessels and causing soft tissue necrosis and bony erosion. Urinary Tract Infections Patients with diabetes have an increased risk of asymptomatic bacteriuria and pyuria, cystitis, and, more important, serious upper urinary tract infection. [3, 4] Intrarenal bacterial infection should be considered in the differential diagnosis of any patient with diabetes who presents with flank or abdominal pain. Pyelonephritis makes control of diabetes more difficult by causing insulin resistance; in addition, nausea may limit the patient's ability to maintain normal hydration. Treatment of pyelonephritis does not differ for patients with diabetes, but a lower threshold for hospital admission is appropriate. Skin and Soft Tissue Infections Sensory neuropathy, atherosclerotic vascular disease, and hyperglycemia all predis Continue reading >>

Why Are Infections A Concern If I Have Diabetes?

Why Are Infections A Concern If I Have Diabetes?

If you have diabetes, you have a higher risk of infections than people who don’t have diabetes. Infections you are more likely to have include: Bladder or kidney infections Thrush, gum disease, and other mouth infections Fungal infections, such as athlete’s foot and nail and skin infections Infections of the vagina, especially yeast infections Wound infections Foot infections Even a small cut on the foot, for example, may not heal well and may develop into a serious, life-threatening problem requiring amputation of your foot. There are several reasons you may have more infections because of your diabetes: High blood sugar levels seem to help the growth of some bacteria and yeast. Poor blood flow can make it hard for the body to fight infection in even small scrapes and cuts. High blood sugar levels may make it harder for your immune system to fight infections. You may not feel injuries to your feet, legs, or hands because of nerve damage and numbness. Without treatment the injuries may get infected. How are the infections treated? Most importantly, your diabetes must be controlled. Because some bacteria and yeast seem to thrive when blood sugar is high, part of the infection treatment includes good control of your blood sugar. Your healthcare provider will prescribe antibiotics or antifungal medicine for your infection. If your foot or leg is infected, you will probably have to rest your foot or leg for days or weeks, depending on how severe the infection is and how quickly it’s healing. You may need physical therapy treatments to help your foot heal. The therapist may also check how you are walking, how well your shoes fit, and if your shoes protect your feet. Sometimes a foot specialist (podiatrist) may help with your foot care. If you are having foot problems, Continue reading >>

Susceptibility To Infections In Persons With Diabetes Mellitus

Susceptibility To Infections In Persons With Diabetes Mellitus

INTRODUCTION It is widely accepted by both the medical profession and the general public that diabetics have an increased propensity to develop infections. Although several epidemiologic studies have shown that diabetics receive treatment for infections more often than non-diabetics, the magnitude of the effect of diabetes on the risk of infection remains an active research question. Host- and organism-specific factors that may explain why people with DM are more susceptible to particular infections will be reviewed here. The clinical features, diagnosis, and treatment of specific infections that appear either to be more prevalent in diabetics or to have unique features when they occur in diabetics are discussed separately. These infections include: Foot infections (see "Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities") Superficial fungal infections, such as oral candidiasis, onychomycosis, and intertrigo (see "Clinical manifestations of oropharyngeal and esophageal candidiasis" and "Onychomycosis: Epidemiology, clinical features, and diagnosis" and "Candidal intertrigo") Continue reading >>

Diabetes And The Risk Of Infection-related Mortality In The U.s.

Diabetes And The Risk Of Infection-related Mortality In The U.s.

Abstract OBJECTIVE—To determine whether diabetes predicts infection-related mortality and to clarify the extent to which this relationship is mediated by comorbid conditions that may themselves increase risk of infection. RESEARCH DESIGN AND METHODS—We performed a retrospective cohort study using the Second National Health and Nutrition Examination Survey Mortality Study of 9,208 adults aged 30–74 years in 1976–1980. We defined demographic variables, diabetes, cardiovascular disease (CVD), and smoking by self-report; BMI, blood pressure, and serum cholesterol from baseline examination; and cause-specific mortality from death certificates. RESULTS—Over 12–16 years of follow-up, 36 infection-related deaths occurred among 533 adults with diabetes vs. 265 deaths in 8,675 adults without diabetes (4.7 vs. 1.5 per 1,000 person-years, P < 0.001). Diabetes (RR 2.0, 95% CI 1.2–3.2) and congestive heart failure (2.8, 1.6–5.1) were independent predictors of infection-related mortality after simultaneous adjustment for age, sex, race, poverty status, smoking, BMI, and hypertension. After subdividing infection-related deaths into those with (n = 145) and without (n = 156) concurrent cardiovascular diagnoses at the time of death, diabetic adults were at risk for infection-related death with CVD (3.0, 1.8–5.0) but not without CVD (1.0, 0.5–2.2). CONCLUSIONS—These nationally representative data suggest that diabetic adults are at greater risk for infection-related mortality, and the excess risk may be mediated by CVD. Although diabetes is widely believed to predispose serious infection and the experimental literature supports an association between diabetes and infection, reviews of this topic have concluded that strong epidemiological evidence linking diabetes to Continue reading >>

Increased Risk Of Common Infections In Patients With Type 1 And Type 2 Diabetes Mellitus

Increased Risk Of Common Infections In Patients With Type 1 And Type 2 Diabetes Mellitus

Background. Clinical data on the association of diabetes mellitus with common infections are virtually lacking, not conclusive, and often biased. We intended to determine the relative risks of common infections in patients with type 1 and type 2 diabetes mellitus (DM1 and DM2, respectively). Methods. In a 12-month prospective cohort study conducted as part of the Second Dutch National Survey of General Practice, we compared 705 adult patients who had DM1 and 6712 adult patients who had DM2 with 18,911 control patients who had hypertension without diabetes. Outcome measures were medically attended episodes of infection of the respiratory tract, urinary tract, and skin and mucous membranes. We applied multivariable and polytomous logistic regression analysis to determine independent risks of infections and their recurrences in patients with diabetes, compared with control patients. Results. Upper respiratory infections were equally common among patients with diabetes and control patients. Patients with diabetes had a greater risk of lower respiratory tract infection (for patients with DM1: adjusted odds ratio [AOR], 1.42 [95% confidence interval {CI}, 0.96–2.08]; for patients with DM2: AOR, 1.32 [95% CI, 1.13–1.53]), urinary tract infection (for patients with DM1: AOR, 1.96 [95% CI, 1.49–2.58]; for patients with DM2: AOR, 1.24 [95% CI, 1.10–1.39]), bacterial skin and mucous membrane infection (for patients with DM1: AOR, 1.59 [95% CI, 1.12–2.24]; for patients with DM2: AOR, 1.33 [95% CI, 1.15–1.54]), and mycotic skin and mucous membrane infection (for patients with DM1: AOR, 1.34 [95% CI, 0.97–1.84]; for patients with DM2: AOR, 1.44 [95% CI, 1.27–1.63]). Risks increased with recurrences of common infections. Conclusions. Patients with DM1 and DM2 are at in Continue reading >>

People With Diabetes At Higher Risk Of Nail Fungus Infection

People With Diabetes At Higher Risk Of Nail Fungus Infection

Understanding nail fungus Although 8 percent of the general population is infected with nail fungus, this figure climbs to 30 percent in people living with diabetes. If left untreated, the fungus can degenerate further, eating away at the nail and separating it from the nail bed, which can cause pain and sometimes even emit a foul odour. Fungal infections tend to happen more in toenails than fingernails for several reasons: slow growth (they grow only 1-2mm per month), poor blood circulation in the feet and toes, and being kept in the dark, moist environment of socks and shoes. “People with diabetes are at an increased risk of developing nail fungus infections and also more likely to face complications," “Identifying fungal foot infections is based on clinical signs, and should be suspected whenever the nail becomes thicker and the colour looks abnormal, like a yellow or discoloured white,” explains Mariam Botros, Director of Diabetic Foot Canada. “It’s not just a cosmetic problem, it can lead to serious consequences, and can be transmitted to family members, or spread in public places such as pools and gyms.” High blood sugar in diabetics The elderly and people suffering from athlete’s foot are also at risk, she adds. However, people with diabetes are particularly susceptible to nail fungus because their high blood sugar levels alter their immunity. The severity of the infection is based on the number of nails infected and the percentage of each nail infected. Under this criteria, approximately 28 percent of patients have mild disease, 40 percent have moderate and 32 percent have severe disease, notes Botros, citing an independent report on treatment. “People with diabetes are at an increased risk of developing nail fungus infections and also more likel Continue reading >>

Diabetes Mellitus And Infectious Diseases: Controlling Chronic Hyperglycemia

Diabetes Mellitus And Infectious Diseases: Controlling Chronic Hyperglycemia

As the incidence of diabetes mellitus continues to rise, common focus areas for diabetes control are blood glucose levels, diet, and exercise. Addressing and controlling these factors as well as other factors associated with diabetes are essential for a better quality of life; however, awareness of an increased risk of infections is also warranted in diabetes patients with chronic hyperglycemia. The immune system is comprised of two subcategories: innate immunity and adaptive immunity. Innate immunity, the first line of defense, is activated when a pathogen initially presents itself. This portion of immunity is inherited at birth and is not specific in its mechanism of defense. In addition, it serves the overall immune system by alerting specific cells of pathogen invasion to activate the adaptive immune system. The innate immune system has physical and chemical mechanisms of response. These include but are not limited to sneezing, coughing, sweating, maintenance of normal body temperature, and gram-positive normal flora on the skin. Adaptive immunity is a very specific aspect of a properly functioning immune system that provides protection against previous infections experienced by the host. These responses are mediated by lymphocytes, which consist of natural killer (NK) cells, B cells and T cells. Vaccinations and exposure to pathogens benefit the adaptive immune system by establishing immunologic memory. In the event of another attack by the same foreign organism, the adaptive immune system is able to provide a more efficient response. Complications of Chronic Hyperglycemia Patients with uncontrolled diabetes are considered immunosuppressed due to the negative effects of elevated blood sugars on the immune system. Hyperglycemia impairs overall immunity through diffe Continue reading >>

Diabetes Mellitus

Diabetes Mellitus

Poorly controlled diabetic patients are at risk for numerous oral complications such as periodontal disease, salivary gland dysfunction, infection, neuropathy, and poor healing. Diabetes mellitus (diabetes) is a common chronic disease of abnormal carbohydrate, fat, and protein metabolism that affects an estimated 20 million people in the United States, of whom about one third are undiagnosed. There are two major forms recognized, type-1 and type-2. Both are characterized by inappropriately high blood sugar levels (hyperglycemia). In type-1 diabetes the patient can not produce the hormone insulin, while in type-2 diabetes the patient produces insulin, but it is not used properly. An estimated 90% of diabetic patients suffer from type-2 disease. The causes of diabetes are multiple and both genetic and environmental factors contribute to its development. The genetic predisposition for type-2 diabetes is very strong and numerous environmental factors such as diet, lack of exercise, and being overweight are known to also increase one’s risk for diabetes. Diabetes is a dangerous disease which affects the entire body and diabetic patients are at increased risk for heart disease, hypertension, stroke, kidney failure, blindness, neuropathy, and infection when compared to nondiabetic patients. Diabetic patients also have impaired healing when compared to healthy individuals. This is in part due to the dysfunction of certain white blood cells that fight infection. The most common test used to diagnose diabetes is the fasting blood glucose. This test measures the glucose levels at a specific moment in time (normal is 80-110 mg/dl). In managing diabetes, the goal is to normalize blood glucose levels. It is generally accepted that by maintaining normalized blood glucose levels, one Continue reading >>

Diabetes And Urinary Tract Infections: What You Need To Know

Diabetes And Urinary Tract Infections: What You Need To Know

The urgent need to go. The burning pain when you do. The cloudy, foul-smelling urine. If you've experienced a urinary tract or bladder infection, you'd probably prefer to avoid another one. Unfortunately, if you have diabetes, you are up to twice as likely as those without the disease to develop these often painful infections. They’re especially common among women. But there’s a lot you can do to avoid them and to ease your discomfort when they do strike. Making healthy lifestyle choices is key to managing type 2 diabetes, but it can be hard to stay on track. Dr. Anthony Cardillo explains that focusing on diet, exercise and stress reduction can help you maintain control of your diabetes. 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. Why Diabetes Poses a Risk Urinary tract infections, or UTIs, occur when bacteria or other bugs invade your body’s drainage system. Normally, your immune defenses banish these bugs before they can grow and multiply. But if you have diabetes, the following factors interfere: Diabetes impairs some parts of your immune response. You have fewer white blood cells and T cells to fight off invading bacteria, viruses, and fungi. For the same reason, diabetics often develop UTIs caused by less commonly encountered germs. Routine antibiotics may be ineffective. Nerve damage can keep your bladder from emptying, either by weakening muscles or scrambling the signals between your brain and urinary system. Urine that remains in your body too long poses a greater infection risk. Sugar in your blood and urine can also contribute to a greater risk for UTI. Besides pain and Continue reading >>

Diabetes And Infection: How To Spot The Signs

Diabetes And Infection: How To Spot The Signs

Diabetes can slow down your body's ability to fight infection. The high sugar levels in your blood and tissues allow bacteria to grow and help infections develop more quickly. Common sites for these problems are your bladder, kidneys, vagina, gums, feet, and skin. Early treatment can prevent more serious issues later on. What to Look For Most infections in people with diabetes can be treated. But you have to be able to spot the symptoms. Tell your doctor immediately if you have any of the following: Fever over 101 F Pain, tenderness, redness, or swelling Wound or cut that won't heal Red, warm, or draining sore Sore throat, scratchy throat, or pain when you swallow Sinus drainage, nasal congestion, headaches, or tenderness along upper cheekbones White patches in your mouth or on your tongue Flu-like symptoms (chills, aches, headache, or fatigue) or generally feeling "lousy" Painful or frequent peeing or a constant urge to go Bloody, cloudy, or foul-smelling pee *CGM-based treatment requires fingersticks for calibration, if patient is taking acetaminophen, or if symptoms/expectations do not match CGM readings, and if not performed, may result in hypoglycemia. Please see important risk and safety information. Continue reading >>

Infections In Patients With Diabetes Mellitus: A Review Of Pathogenesis

Infections In Patients With Diabetes Mellitus: A Review Of Pathogenesis

Go to: Diabetes mellitus (DM) is a clinical syndrome associated with deficiency of insulin secretion or action. It is considered one of the largest emerging threats to health in the 21st century. It is estimated that there will be 380 million persons with DM in 2025.[1] Besides the classical complications of the disease, DM has been associated with reduced response of T cells, neutrophil function, and disorders of humoral immunity.[2–4] Consequently, DM increases the susceptibility to infections, both the most common ones as well as those that almost always affect only people with DM (e.g. rhinocerebral mucormycosis).[4] Such infections, in addition to the repercussions associated with its infectivity, may trigger DM complications such as hypoglycemia and ketoacidosis. This article aims to critically review the current knowledge on the mechanisms associated with the greater susceptibility of DM for developing infectious diseases and to describe the main infectious diseases associated with this metabolic disorder. Continue reading >>

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