Diabetes: Infections

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 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.

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

• You may not feel injuries to your feet, legs, or hands because of nerve damage and 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 make it harder for your immune system to fight infections.
• Poor blood flow in your 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 or weeks. 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, you may need special shoes specially designed to protect your feet from injury.

Your infection will take longer to heal than an infection in someone who doesn’t have diabetes because the blood supply to your feet and legs is often not as good. 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 people who have diabetes. You will probably 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. But the cornerstone of preventing amputations and other complications is good blood sugar control.

How can I take care of myself?

• Be aware of your increased risk of infections and the serious problems caused by infections if they are not treated.
• 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.
• Check your feet every day.
• Call your healthcare provider right away if:
  • You have an injury or sore on your feet or legs, even if it’s small.
  • You have any tingling, numbness, or change in color or feeling in your fingertips and toes.
  • An area on your skin is hot, red, swollen, or painful
  • You have a fever.
  • You have a wound that is not healing or is getting bigger.
  • You have red streaks around a wound.
  • You have drainage that smells bad from a wound.
  • You have a craterlike wound (ulcer) on your foot or leg.

How can I avoid getting infections?

• Never go barefoot, not even in the house. 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 treat corns or calluses by yourself. Especially do not treat them with razor blades or chemical products. Ask for help from your healthcare provider.
• 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.