Diabetics are vulnerable to infection by a host
of organisms primarily due to their increased virulence in the favorable
environment offered by increased glucose contents in tissues and blood.
Diabetics show low immunity to fight out
infections due to disturbance in the immune system. The overall condition of
the diabetic patient is a state of metabolic stress under which most functions
of the body are stressed for one or the other reasons.
The patient’s inappropriate lifestyle, unhealthy
diet and overweight add to the problems and further aggravating disease and
chances of infection and associated complications.
Diabetics are especially vulnerable to
infections by germs like Streptococus pneumoneae, influenza virus, Mycobacterium
tuberculosis, Escherichia coli, Proteus sp., Klebsiella, Candida sp.,
Hepatitis C virus and enteroviruses.
In general, diabetics are at a greater risk of
contracting respiratory infections, in particular influenza, and tuberculosis.
Chances of developing multi-drug resistant tuberculosis are higher in
diabetics.
Inadequate glycemic control over long period
causes damage to blood vessels and this condition promotes infection.
Pyelonephritis may be caused by E.coli
or Proteus sp and also produces renal
abcess and necrosis.
Renal and perinephric abcess caused by E.coli may cause symptoms of fever,
backache, and polyurea. Common fungal agents such as Candida sp. may become pathogenic in diabetic condition and cause
serious damage and disease.
In diabetic patients, the body’s metabolism is
in a disturbed state giving rise to increased blood sugar, immune dysfunction,
disturbed blood circulation (due to micro- and macro-angiopathies) and nerve
and brain damage.
Decreased antibacterial activity of urine,
dysmotility of urinary tract and reduced intestinal output add to deteriorating
physiologcal environment. These situations provide a favourable environment for
germs to thrive.
Low immunity reduces body’s natural ability
to fight infections and increases vulnerability to infectious diseases. Diabetes
is known to suppress the immune response by impairing chemotaxis and
phagocytosis facilitating progression of the disease.
Damage to fine blood capillaries affects proper
blood circulation to cells and tissues thus leading to their damage.
Prevention and control of diabetes is the
foremost need in order to prevent any infection. In a diabetic, infection may
be the first manifestation of disease and a precipitating factor for its
complications.
Proper hygiene, regular care of foot infection,
and prompt treatment of any infection are measures to prevent against serious
complications.
Patients’ increased chances of catching
respiratory infections require prevention by using anti-pneumococcal and
influenza (H1N1) vaccines.
Symptoms are common to any other infection in
the body, like fever, sweating, skin rash, non-healing foot wounds, sore
throat, nasal congestion, white patches on mouth or tongue, painful urination,
bloody urine, vaginal itching as some most
commonly observed symptoms.
Treatment and management of infections in
diabetic patients primarily focus on immediate and the long-term measures: immediate
effort to control infection by using suitable antibiotics and the control of
blood sugar by using drugs.
The long-term measures are proper control of
blood sugar, healthy and nutritious diet. The other measures are: light
exercise, regular walking and physical activity to increase gastrointestinal
motility; fibrous diet to control constipation; and Increased water intake to
flush out toxins and kidney infection.
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