Diabetes mellitus is one of the oldest ailments ever known to man. To give insight into how long it has lived with us, we must look at its origin. The etymology of this disorder is traced to ancient Egypt around 1500 B.C. Indeed, it was when the first set of cases were discovered. However, the disease was first recorded as an English word in 1425. But then, it is noteworthy that Diabetes is a Greek word while Mellitus is a Latin word. English doctor Thomas Willis introduced Mellitus to Diabetes in 1675 because of the sweet taste of patients’’ urines. Today, the ailment is known as Diabetes Mellitus. All this goes to show that the disease has lived with us for donkey’s years. The question now is, “Why are diabetics prone to infections?” Well, let’s find out.
Why People with Diabetes Mellitus Have Infections
Diabetes mellitus, a metabolic disorder due to insulin deficiency, causes increased glucose levels in the blood. Hyperglycemia, the increased blood glucose, produces harmful effects by the non-enzymatic glycation of proteins. These proteins are abundantly present in people living with diabetes with poor glycemic control. Well, glycation causes impairment of the host proteins involved in the inflammatory response, thus predisposing to infections.
People with diabetes are more prone to infections than non-diabetic individuals. The infection risk rises in proportion with the levels of blood glucose. Some rare, potentially fatal infections occur exclusively in patients with diabetes. Foot infections, malignant external otitis, rhinocerebral mucormycosis, and gangrenous cholecystitis occur primarily in diabetes. Candida albicans is also common. Women with poor glycemic control are more prone to vulvovaginal candidiasis than euglycemic women.
The greater frequency of infection in diabetes is attributed to the hyperglycemic environment, which impairs normal body defense mechanisms. Host factors that predispose an individual to infections are multifactorial and depend on many factors. These factors include tissue involved, the type of protective immune response required, and the virulence of a pathogen. Hyperglycemia-related impairment of the immune response, vascular insufficiency, and Peripheral neuropathies are some other factors that increase the risk of infections.
Hyperglycemia-related impairment of the immune response is due to decreased chemotaxis and phagocytosis of neutrophils, glycation of immunoglobulins, and abnormal T-cell response. In addition, the increased susceptibility to oxidative stress due to decreased NADPH levels and decreased production of inflammatory cytokines can be key factors. Cell-mediated immunity, opsonization, humoral immunity, and bactericidal activity are impaired in people living with diabetes. Decreased immune response increases the susceptibility of an individual to various infections.
Common Symptoms and Treatment
Vascular insufficiency Hyperglycemia increases the risk of atherosclerosis development, which often results in the decreased blood supply to various organs. Decreased circulation causes hypoxic damage to the local tissues, which increases the growth of anaerobic organisms. It also impairs local inflammatory responses. Peripheral neuropathies and minor local trauma in patients with diabetes may result in skin ulcers. In turn, those lead to diabetic foot infections, which are often either unnoticed or ignored until an infection occurs. Patients with diabetes-associated autonomic neuropathy may develop urinary retention and stasis that, which predisposes them to develop urinary tract infections.
Diabetes-induced infections are mainly due to increased blood glucose. Prompt treatment with antimicrobial can reduce infections. However, attempts should always be made to decrease glucose concentration. Necessary precautions should be taken to control glycemic index. Aseptic precautions are practiced before surgery to reduce surgical site infections and no surgery until the glycemic index comes under control. Careful blood sugar control is crucial during any infection to promote healing and prevent further complications related to the disease. Can diabetes mellitus be treated? It sure can. Contact a doctor to learn more.