Yeast, Bacterial and Fungal Infections Caused By Diabetes
DIABETES YEAST, FUNGAL AND BACTERIAL INFECTIONS
DIABETES YEAST INFECTION
Yeast are a type of microscopic fungus. The type of yeast that most commonly causes infections in humans is called Candida. Yeast like to find moist places to grow that can provide a source of nutrients. If you have diabetes you are at a greater risk for yeast infection because of the high glucose content in your body. Yeast often grow in warm moist places, such as skin crevices in the armpit and groin or under the breasts, and in mucous membranes such as the mouth, rectum, and vagina. Yeast infections can be very uncomfortable, but they are easily treated.
DIABETES YEAST INFECTION SYMPTOMS
The symptoms of a yeast infection will vary depending on what part of the body is infected. In the mouth, a yeast infection is called thrush. The tongue and cheeks may be covered with a thick, white, cheesy substance. Near the corners of the mouth, yeast infections are usually red and moist. If Candida infects skin folds around the breasts, groin or anus, you may notice a bright red spot surrounded by smaller dotted spots. These smaller dots often have central yellow pustules. Vaginal yeast infections are common in women with diabetes. If you have vaginal yeast infection, you might notice a white curd-like discharge. Yeast infections of the vagina and skin are often very itchy. If you have a vaginal yeast infection, you may also notice a burning sensation when you urinate.
What You Should Do
The first step in combating any kind of yeast infection is to control your blood glucose levels. You should also try to avoid or reduce stress and get plenty of rest. Also keep areas of infected skin clean and dry. Try to keep moisture from accumulating around the corners of your mouth.
You should also contact your doctor, who may prescribe an antifungal medication to kill the yeast. You may use an antifungal rinse in your mouth—swish it around and spit it out. Or, you may choose an oral lozenge that dissolves slowly to kill yeast. Yeast that are resistant to these topical agents may respond to a drug that is swallowed, such as fluconazole. Topical antifungal agents such as nystatin or terbinafine seem to work well on infections at the corners of the mouth.
To treat yeast infections in the folds of skin on the body, it is important to keep the skin clean and dry. This is to prevent a bacterial infection from also developing, which can lead to the destruction of skin tissue. After cleaning and drying the area, apply a topical antifungal cream.
Vaginal yeast infections can be treated with over-the-counter or prescription antifungal creams or suppositories. Make sure to use a cream that is designed for use in the vagina. If your infection is difficult to clear up, you may need an oral antifungal agent. You may need to be examined by your doctor, since vaginal infection often have symptoms similar to bladder infections. If you have a yeast infection in the rectal area, cleanse the area with water, then apply an antifungal cream.
If your yeast infections tend to recur, as they often do in people with diabetes, your doctor may suggest a preventive program. This could include using antifungal powders on your skin and regularly applying topical antifungal creams to infected sites to prevent reinfection
DIABETES FUNGAL INFECTIONS
In addition to yeast, other types of fungi can infect your body. Fungal infections can occur between your toes, in your groin, on the bottom of your feet, on the palms of your hands, or under your nails. Fungal infections can be dangerous if you have diabetes, because they can create an area of irritation that can provide an opening for a more serious bacterial infection.
DIABETES FUNGAL INFECTIONS SYMPTOMS
Symptoms of fungal infections depend on the sites at which they occur. If your feet become infected, you will probably first notice white and softened skin between your toes. This often occurs between the fourth and fifth toes, but it can quickly spread to the other toes.
Fungal infections of the groin are more common in men than in women. The infection often starts as an irritation of the inner thighs. You may notice a red, scaly rash. Usually the scrotum is not affected. You can experience a dry, powdery scaling that often starts in a small area on the soles of your feet and the palms of your hands. It then spread to the sides of the feet in what is sometimes called a ‘moccasin-type’ of infection.
Fungal infections of the nail are difficult to cure and perhaps the most unsightly of all fungal infections. The nail tends to become thick and yellow. They are most common in the toenails, but can spread to other nails of the feet and hands. You may also notice dark streaks in infected nails. The nail can become dull and eventually the entire nail can become soft and crumbly and may fall off.
What You Should Do
Talk to your doctor if you develop any of the symptoms of a fungal infection. She may prescribe or recommend a topical antifungal cream. To treat your feet and toes, dry well between your toes after bathing and apply an antifungal cream, such as clotimazole or miconazole, twice a day. Once the infection clears, use an antifungal powder on a daily basis. Also wear shoes and socks that breathe well and minimize excess sweating of your feet.
For infections of the groin, keep the area clean and dry and apply a topical antifungal cream once or twice a day. Use an antifungal powder once the infection has cleared. Avoid tight-fitting clothing and activities that promote excess friction and sweating. Boxer shorts can help prevent excess sweating.
For infections of the soles of the feet and palms of the hands, try applying a topical antifungal cream twice daily. If that doesn’t work, you may need to take oral antifungal drugs. For nail infections, you may need to see your doctor for a prescription medication. Nails tend to be resistant to topical treatments. You may need to have material from your nails cultured.
DIABETES BACTERIAL INFECTION
Bacteria can infect the outer layer of your skin, the epidermis, or the second, deeper layer of skin, called the dermis. Superficial bacterial infections can usually be treated easily. However, when bacteria infect the deeper layer of the skin and make their way to underlying tissue, the outcome can be more serious.
Diabetes Impetigo
Impetigo is an infection of the outer layer of skin, the epidermis, caused by the Staphylococcus aureus bacteria
Diabetes Impetigo Symptoms
An impetigo infection appears as a yellow-crusted spot on a red base. It often affects the face and hands. Sometime it may also blister.
What You Should Do
A localized impetigo infection can be treated with an antibacterial ointment, such as mupirocin or bacitracin. Once the skin infection has cleared up, your doctor may want to take samples from your nostrils, groin, or other parts of your body to make sure the bacteria are not lurking there, ready to infect again.
Diabetes Erythrasma
Erythrasma is caused by the bacteria Corynebacterium minutissimum that tend to infect folds of the skin, especially under the arm and in the genital regions.
Diabetes Erythrasma Symptoms
Erythrasma manifests itself as a brownish itchy patch of skin. It tends to look like some fungal infections. Under ultraviolet light, these patches emit a red fluorescent glow. The rash usually does not produce any discomfort or pain. It can sometime itch and sometimes cause a breakdown of skin tissue.
What You Should Do
If symptoms do occur, talk to your doctor. Erythrasma can be treated successfully with the antibiotic erythromycin
Diabetes Erysipelas
Erysipelas is an infection that affects the deeper dermal layer of skin tissue. The grave danger with this infection, especially for someone with diabetes, is its tendency to spread quickly
Diabetes Erysipelas Symptoms
Erysipelas initially appears as hot, red, hive-like spots on one side of the face, but it can spread to other parts of your body. You may also develop fever and may feel run-down
What You Should Do
Notify your doctor right away if you notice any of the symptoms of erysipelas. If you cannot reach your doctor, get to the nearest hospital right away. You will most likely require intravenous therapy with antibiotics
Diabetes Carbuncles and Furuncles
Carbuncles and furuncles are caused by the Staphylococcus aureus bacteria. The bacteria often colonize in the nose and then spread to the skin, usually infecting hair follicles
Diabetes Carbuncles and Furuncles Symptoms
Infected hair follicles can develop into larger and deeper infections called furuncles. These can then progress to carbuncles, larger lesions that often occur on the back of the neck. Carbuncles appear as warm, tender, boil-like swellings that sometimes drain pus
What You Should Do
If your infection is mild, it may be easily cured with antibiotic therapy. If the infection is more severe, you may need surgical drainage in addition to antibiotics
Diabetes Cellulitis
Cellulitis is an infection caused by Streptococcus aureus. It tends to occur frequently in people with diabetes and the symptoms are usually more severe
Diabetes Cellulitis Symptoms
Cellulitis occurs as a red, tender swelling of the feet or legs. It occasionally affects other parts of the body and tends to spread superficially
What You Should Do
If you experience symptoms of cellulitis, contact your doctor, who will prescribe an antibiotic. Cellulitis responds well to antibiotic therapy. Your condition may appear to get worse in the first 24 hours, but after 36 to 48 hours symptoms should begin to improve. If there is no improvement from antibiotics, contact your doctor right away. Your doctor may need to reevaluate your situation and look for possible microorganisms that may be resistant to the antibiotic you are taking. Your doctor will also be on the lookout for a more serious infection, such as necrotizing fasciitis and cellulitis. If these infections are not caught in the very early stages, you will need an intravenous course of antibiotics
Diabetes Necrotizing Fascitis and Cellulitis
Necrotizing fascitis and cellulitis are life-threatening infections that occur in the soft tissues below the skin. They are caused by a mixture of pathogenic bacteria. Something that is necrotizing can cause death of cells. Necrotizing fasciitis infects soft tissues down to the fascia, the connective tissue that covers your muscle. Necrotizing cellulitis usually affects the muscles. Necrotizing infections are very serious and spread quickly, destroying healthy tissue along the way. They often result in gangrene. Fortunately, these infections are fairly rare. They are more likely to appear in patients with impaired circulation following some sort of trauma. They can also result from deep infections, especially in the legs and genital or rectal areas. Fournier’s gangrene is a necrotizing infection that affects male genitals.
Diabetes Necrotizing Fascitis and Cellulitis Symptoms
Symptoms include severe pain, the appearance of blisters and bleeding into the skin
What You Should Do
Contact your doctor immediately or seek emergency help if you experience any of these symptoms. You will need to be treated at once. Your doctor will need to remove any dead tissue by surgical debridement. This will be followed with an aggressive course of intravenous antibiotics
Diabetes Abscesses
An abscess is a localized, confined area of infection. It tends to occur at the insulin injection site and is apparently caused by using contaminated needles.
Diabetes Abscesses Symptoms
Symptoms include an area of skin, often red and swollen, that contains pus
What You Should Do
Depending on the size of your abscess, your doctor may need to drain it and then treat it with an antibiotic solution. To prevent abscesses, always use clean sterile needles and syringes. Also clean your injection site and the tops of any vials that you use over again and with alcohol or antiseptic
REACTION TO DIABETES MEDICATIONS
Insulin
Local allergic reactions to insulin used to be more common when beef and pork insulins were in common use. However, the purer human recombinant forms of insulin are making this problem a thing of the past. Historically, repeated injections of insulin can cause indentations at the injection site. This condition, known as lipoatrophy, occurs less often with newer, purified insulins. Over the years, fat may accumulate at the injection site in a condition known as hypertrophy.
Symptoms
Symptoms of local reaction to insulin include burning at the injection site, followed by a local outbreak of hives. This reaction, which usually fades in hours to days, can be immediate or delayed. Generalized skin reactions and anaphylactic shock are extremely rare.
Lipoatrophy is characterized by indentations at the injection site due to the loss of fat under the skin. Hypertrophy appears as lumps in the skin near the injection site.
What You Should Do
Most injection site problems can be overcome by switching to human insulin and rotating the injection site
Sulfonylureas
Sulfonylurea drugs are oral agents commonly used to treat type 2 diabetes. Older sulfonylurea drugs may create more problems than newer, second generation drugs. Common effects are skin rashes, which usually appear in the first few months of therapy in 1% to 5% of patients.
Symptoms
Symptoms of an allergic reaction to a sulfonylurea drug include a rash that looks like measles. Hives are more likely to occur after exposure of the skin to the sun and are more frequently found with tolbutamide and chlorpropamide use. If you drink alcohol with one of the older sulfonylureas, you may experience a flushing of your skin, especially your face. This is less common with newer sulfonylurea drugs
What You Should Do
The measles-like rash when taking sulfonylureas usually disappears after a few months of therapy. Report any skin rash to your doctor. If you are experiencing any other kind of rash or skin irritation, your doctor can reevaluate your medication and decide if another drug would suit you better
Sources and References
The Diabetes Problem Solver—Quick Answers to Your Questions About Treatment and Self-Care by Nancy Touchette
Diabetes and Acute Bacterial Skin and Skin Structure Infections by Marco Falcone, Stefano Del Prato et al
Genital Mycotic Infections in Patients with Diabetes by Paul Nyirjesy and Jack Sobel
Clinical Aspects of Fungal Infections in Diabetes by Anna Poradzka, Mariusz Jasik et al
Opportunistic Invasive Fungal Disease in Patients with Type 2 Diabetes Mellitus from Southern China: Clinical features and Associated Factors by Minxi Lao, Chen Li et al
Rich Health Editorial Team
Rich Health Editorial Team is made up of medical practitioners and experienced writers who provide information for dealing with health issues in a simple and easy-to-understand manner
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