Diabetes mellitus is a common disease that causes a number of metabolic disorders that adversely affect the condition of many organs and systems. Changes develop in the heart, blood vessels, kidneys, nerve fibers – these are the most frequent causes of the “diabetics” treatment to a doctor. It is not surprising that doctors have to deal with diabetes mellitus of different profiles. Otolaryngologists are also not an exception, although not much attention is paid to diseases of ENT organs with concomitant diabetes mellitus. Nere DKO suspected diagnosis “diabetes” is exactly the ENT doctor.
Diseases of the ear, nose and throat in patients with diabetes
Diseases of the ear, nose and throat are quite common among the population. According to the observations of experts, in persons suffering from diabetes, they are detected in almost 60%. The figure is not small, which suggests the connection between high blood glucose levels and their development.
Diabetes mellitus aggravates the disease of the ear, nose and throat, making therapy difficult and the prognosis worsens. In addition, there may be restrictions to the conduct of surgical interventions due to a background disease. Known and lethal outcomes from complications of the pathology of ENT organs with concomitant diabetes.
Mechanisms of development of inflammation of ENT organs in diabetes mellitus
To understand why inflammation in patients with diabetes mellitus, it is more common and harder in the ear, throat and nose, you need to know what changes in diabetes develop in the body and in the respiratory mucosa in particular:
- Immune protection weakens, “diabetics” become more susceptible to infection;
- The regenerative abilities of the body are reduced, causing the inflammatory process in the body to be characterized by a slow course, rapid spread, resistance to therapy.
- The presence of micro- and macroangiopathies , neuropathies reduce the possibility of rapid healing and resistance to infectious agents.
Changes in the mucous membrane of the upper respiratory tract in diabetes mellitus:
- The mucociliary clearance is reduced – a local defense mechanism of the respiratory system, carried out due to the presence of cilia on the epithelium lining the respiratory tract, and special mucus produced by glandular cells.
- Also in patients with diabetes there is an increased content of staphylococci on the nasal mucous membranes.
- The mucous membranes of the mouth and pharynx in “diabetics” are characterized by increased dryness (xerostomia).
- And the mucous membrane of the airways undergoes atrophic changes and epithelial metaplasia.
Diseases of the nose and sinuses: sinusitis
Patients with diabetes mellitus often have acute and chronic sinusitis. Acute sinusitis and rhinosinusitis often cause streptococci and hemophilus bacilli. In chronic sinusitis, Staphylococcus aureus and fungal flora are more often detected.
Sinusitis on the background of diabetes occurs for a long time, sluggishly, often with the involvement of other organs in the process – the paranasal sinuses, the orbits of the eyes, the membranes of the brain. The developed purulent complications are life threatening – rhinogenic meningitis, phlegmon of the soft tissues of the face, etc.
Features of ear diseases: otitis
Have their own characteristics and diseases of the ear with elevated blood sugar. Thus, studies of earwax in diabetics have shown that glucose is in its composition. The formation of sulfur in this group of individuals was elevated, such patients often complain of the formation of sulfur plugs, the presence of itching.
Often detecting ear disease in diabetes mellitus – external otitis. In the initial stages of the disease, the erased nature of the course can be worn when the patient is worried about unexpressed pain in the area external auditory canal and itching. With a marked decrease in the immune functions of the body, the disease develops into necrotizing external otitis. At the same time, purulent-necrotic processes develop in the tissues, the process tends to spread.
The disease often develops in the elderly. The process with severe pain in the ear, the release of pus from the external auditory canal. A terrible complication of necrotizing external otitis is osteomyelitis of the temporal bone.
In addition to otitis, the development of boils in the area of the external auditory canal, dermatosis, seborrhea, inflammation caused by fungi is often noted in diabetics.
Diabetic throat diseases
Among the diseases of the throat in persons suffering from diabetes, most often revealed chronic tonsillitis. A special feature is the fact that these two diseases aggravate each other. Thus, chronic tonsillitis in diabetes mellitus is hidden, with the rapid development of complications and difficult to conventional therapy, and diabetes with the development of tonsillitis goes into a stage of decompensation, often with the development of ketoacidosis .
The clinical feature of chronic tonsillitis in diabetics is the erased course — the disease proceeds with subfebrile temperature, indistinct pharyngoscopic signs and early development of purulent complications. The most dangerous complications of tonsillitis is the development of paratonsillarabscesses, mediastinitis, and phlegmon of the neck.
Features of treatment of diseases of ENT organs in diabetes mellitus
Diabetes mellitus complicates the course of diseases of the inflammatory nature of the ENT organs and forces to make adjustments to the treatment. Diseases ear, nose and throat are characterized by a slow and persistent course and are poorly amenable to the usual methods of treatment. In addition, the use of some antibacterial drugs (without them, the treatment of infectious inflammation is impossible) in diabetes mellitus is contraindicated, as they can affect the glycemia level. And the presence of diabetic nephropathy requires dose adjustment of antibiotics. In such a difficult situation, it is difficult for an otolaryngologist to cope alone. Treatment must be carried out jointly by an endocrinologist and an ENT doctor.