Diabetes: Infections

How do infections occur as a complication of diabetes?

Diabetics are especially at risk of getting the following types of infections:

• bladder or kidney infections
• thrush, gum disease, and other mouth infections
• fungal infections
• infections of the vagina
• wound infections
• foot infections.

Even a small cut on the foot, for example, may not heal well and may develop into a potentially life-threatening problem.

There are several reasons you may have more infections because of your diabetes:

• You may not notice injuries to your feet, legs, or hands because of numbness. Without treatment the injuries may become infected.
• High blood sugar levels seem to help the growth of some bacteria and yeast.
• High blood sugar levels may keep white blood cells from fighting infections well.
• Poor blood supply to feet and legs can make it hard for the body to fight infection in even small scrapes and cuts.

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 that foot or leg for days to weeks. You may need physical therapy treatments to help your foot heal. The therapist may also evaluate how you are walking and how well your shoes fit and protect your feet. Sometimes a foot specialist (podiatrist) may help with your foot care.

Your infection will take longer to heal than an infection in a nondiabetic. If there is any question about whether the infection is healing too slowly or if it is too deep to heal easily, you may be referred to a healthcare provider who specializes in treating difficult infections in diabetics. You will likely need to have frequent follow-up visits.

All parts of treating diabetic infections (diabetes control, medicine, physical therapy, and rest), especially infections of the feet and legs, are important in preventing amputations.

How can I take care of myself?

• Be aware of your increased risk of infections and the serious problems caused by infections that are not treated.
• See your provider right away if you have an injury or sore on your feet or legs to make sure you get the correct treatment from the start.
• See your provider right away if you think something is wrong (for example, you have a fever) or if an injury is not healing. Report any tingling, numbness, or change in color or feeling in your fingertips and toes right away.
• Tell your healthcare provider about any discharge from the vagina or penis, changes in the color or odor of your urine, or burning or painful urination.
• Watch for sores in your mouth, lips, tongue, or gums. White, painful patches on your tongue or in your mouth may be thrush. Thrush is a fungal infection that can spread internally to other parts of your body if it is not treated.

How can I avoid getting infections?

• Never go barefoot. Even minor cuts can become seriously infected.
• Examine your feet at the end of each day to make sure there are no reddened areas, cuts, or scrapes that could become infected. Use a mirror to see the bottoms of your feet, if you need to. You may see cuts, sores, or blisters you cannot feel because of nerve damage.
• After bathing, carefully dry your feet, including between the toes, to prevent skin breakdown. Use lotion to moisturize your skin. Skin that is dry and cracked offers openings for bacteria to enter and cause infection. Do not put lotion between your toes because it may keep the skin in that area too moist.
• Do not try to treat corns or calluses by yourself. Especially do not treat them with razor blades or chemical products.
• Take special care trimming your toenails. Learn how to do it properly or have a diabetic foot specialist do it for you. Injuries around the toenails are a common source of foot infections.
• Wear well-fitting socks and shoes to protect your feet from injury.
• Keep your appointments with your healthcare provider for your regular diabetes and foot checks.