Patients with diabetes are more likely to be infectious diseases. Although infections are not considered complications of diabetes, they are often seen by endocrinologists who treat the underlying disease.
Infectious process in diabetes has a number of features:
- Acute and chronic diseases caused by pathogenic microorganisms contribute to the decompensation of carbohydrate metabolism, that is, they make it heavier for diabetes.
- The course of infectious diseases on the background of diabetes is often fulminant, there are even fatal cases.
- Sometimes an infection on the background of diabetes can occur hidden or with minimal clinical manifestations, periodic exacerbations. Such cases are often left without proper treatment.
About the susceptibility of “diabetics” to infections
The susceptibility of patients with diabetes mellitus to infectious diseases is associated with an increased level of glucose in the blood. The relationship between indicators of the protective functions of the body and the degree of carbohydrate metabolism disorders has been proven.
Under conditions of hyperglycemia (elevated blood glucose), the following changes occur in the body:
- Depression of immunity;
- Strengthening the inflammatory response.
Another interesting fact is that some microorganisms, getting into the environment with a high content of glucose, begin to show their special virulence properties that prevent the human body to develop protection against them.
For some microorganisms, biological fluids with a high content of “sugar” are the most favorable nutrient medium. Therefore, in patients with diabetes mellitus with inflammatory diseases, pathogens typical for various organs are isolated.
Important!
Often, developing purulent-infectious diseases may be a sign of elevated “blood sugar”. To confirm or refute the diagnosis of diabetes, you need to contact a specialist. You can make an appointment with an endocrinologist by phone right now.
Diabetes and soft tissue infections
In patients with diabetes mellitus, minor wounds heal more slowly – scratches, cuts, burns. Often, even minor damage to the skin caused, for example, during a manicure or pedicure is complicated by suppuration and does not heal for a long time. This is due to the presence of polyneuropathy, microangiopathy with a long-standing primary disease.
The same applies to the healing of postoperative wounds. In patients with diabetes, the postoperative period occurs with a high incidence of complications and frequent deaths. Unlike people with normal “blood sugar”, with the same surgical interventions, they spend more time in the hospital.
Urinary tract infection in diabetes
Diabetes mellitus often occurs with inflammatory diseases of the urinary tract of infectious etiology. The following factors predispose to their development:
- Diabetic nephropathy;
- Violation of the innervation of the bladder due to the development of diabetic neuropathy, as a result of which atony of the bladder develops, vesicoureteral reflux;
- Elevated levels of glucose in the urine – is a favorable environment for the growth of many microorganisms.
Urinary tract infections with diabetes have their own special characteristics:
- More often proceed hard, with the development of complications;
- If in patients with normal blood glucose the pathogen in urinary infections is Escherichia coli, then diabetics also have other gram-negative flora, and often fungi, such as Candida ;
- Renal tissue is involved in the inflammatory process much more often than in people without diabetes;
- In diabetes mellitus, antibiotic resistant pathogens are often detected. Therefore, an infectious disease of the urinary tract often remains undertreated , resulting in a chronic process. Apparently, for this reason, diabetics are often diagnosed with chronic relapsing pyelonephritis.
Urinary infection in patients with diabetes mellitus often occurs with the following complications:
- Kidney abscess;
- Peripephral abscess;
- Emphysematous pyelonephritis;
- Urosepsis .
The development of complications leads to decompensation of diabetes mellitus, even with the development of a formidable condition – ketoacidosis . Therefore, timely treatment with the correct selection of antibacterial drugs helps reduce the risk of complications.
Respiratory Infections in Diabetes
Note and feature of the course of diseases of organs breathing in individuals with diabetes. They often suffer from community-acquired pneumonia. Wherein pneumonia in diabetes has an acute onset with rapid involvement in the process of the pleura, which is accompanied by a pronounced pain symptom.
Most often, inflammation in the lungs occurs in the form of severe lobar pleuropneumonia.
It is also noted that diabetics tolerate the flu. This viral disease is severe, with complications, and often they have to be hospitalized due to a serious condition.
Tuberculosis
Tuberculosis is considered a disease that often accompanies diabetes. This infection occurs 3 times more often in diabetics than in individuals with normal blood glucose levels.
Moreover, the disease has its own characteristics:
- Tuberculosis is more often detected in patients with long-term diabetes mellitus (7 years or more);
- It develops against the background of complicated, subcompensated , decompensated forms of diabetes.
- Often, drug-resistant forms of tubercle bacillus are detected.
- Most often, these patients are bacterial excreta .
- The disease occurs with severe intoxication syndromes and bronchopulmonary syndrome (cough, sputum discharge).
- In diabetes mellitus, infiltrative tuberculosis and tuberculoma are more often diagnosed .
- Treatment of tuberculosis in the presence of diabetes mellitus is carried out under the supervision of doctors of two specialties: an endocrinologist and a phthisiologist. Only with joint antimicrobial therapy and compensating for disorders of carbohydrate metabolism, the disease can be successfully cured.
Diseases of ENT organs of infectious nature
Among the diseases of the ear, nose and throat in patients with diabetes mellitus, the development of malignant external otitis is most often noted. This is a dangerous disease that can be fatal due to its complications. And there is a malignant external otitis in 90% in combination with diabetes. The remaining 10% include persons with weakened immunity – HIV-infected, suffering from malignant tumors, patients after organ transplantation, etc.
The development of the disease is associated with changes that have developed as a result of diabetes mellitus in the form of microangiopathy (inflammation of the inner lining of small vessels and their obliteration).
The disease begins with purulent inflammation in the region of the outer ear, gradually moving to the surrounding soft tissues, and then to the temporal bone and the base of the skull, causing osteomyelitis.
Mucormycosis
Among all registered cases of mucormycosis, approximately half are in patients with diabetes mellitus in the stage of decompensation or ketoacidosis . Mucormycosis is fungal disease related to opportunistic infections. The causative agent is zygomycete class mushrooms.
According to the localization of the inflammatory process, the following forms of mucormycosis are distinguished :
- Rinocerebral – the pathological process is localized in the sinuses, goes to the brain;
- Pulmonary;
- Gastrointestinal;
- Cutaneous;
- Disseminated – applies to many organs and systems;
- Mucormycosis of rare forms (in the form of endocarditis, peritonitis, etc.).
In patients with diabetes mellitus, the most common is rhinocerebral form of mucormycosis . The pathological process takes place in the sinuses, which is clinically manifested by pain in the area of the paranasal sinuses, the presence of purulent discharge from the nose, and there may be swelling of the soft tissues of the face. The process quickly spreads to the bones of the facial skull, to the brain, which can be fatal. Until the moment of treatment with antifungal drugs, patients with mucormycosis in 100 % of cases died from complications.