If you have diabetes, your body is more likely to develop an infection, and those infections are also more prone to spread quickly, get worse, or require medical care. Elevated blood sugar levels can weaken the body’s immune system, leaving it more susceptible to attacks by germs and other pathogens. The resulting infections, which can happen most anywhere in the body, can range from annoying to life-threatening, but if an open sore or wound is affected, seek medical help immediately.
High blood sugar, also known as hyperglycemia, is the hallmark symptom of diabetes, and it puts extra stress on your body. That can impair the body’s immune system and allow bacteria and fungi to thrive from your mouth down to your feet.
“When the body is under high levels of stress, the immune system can be affected, resulting in a weaker and less robust response to infection,” says Lisal Folsom, MD, the medical director of the adult endocrinology division at the Wendy Novak Diabetes Institute at Norton Healthcare in Louisville, Kentucky.
High blood sugar can cause other complications that make it easier for infections to quickly take hold and start snowballing.
Higher levels of inflammation, which damage the body’s organs over time
Blood vessel damage, which reduces healthy blood flow
Neuropathy or nerve damage, which makes you more likely to tear your skin
The first line of defense against infections is keeping your blood sugar levels as close to your target range as possible. Healthy glucose levels are the best way to make sure that your body can give 100 percent when fighting harmful germs, making it easier to recuperate.
The feet of a person with diabetes can have poor circulation and reduced sensation, both of which can result in unnoticed or worsening bacterial and fungal infections. These infections can become severe enough to require a foot or leg amputation.
Poor circulation is typically the result of peripheral artery disease, a type of blood vessel damage that can develop in people with diabetes. Peripheral artery disease reduces healthy blood flow to your feet, which makes it harder for your immune system to deliver infection-fighting white blood cells and nutrients to the site of a brewing infection.
Reduced sensation stems from issues like peripheral neuropathy, or damage to the nerves in your extremities.
“If a person with neuropathy injures their feet, they might not notice right away due to lack of sensation. If the injury isn’t noticed and treated in a timely manner, an infection can develop,” Dr. Folsom says.
The right treatment will depend on the type of infection a person has and how severe it is. Your provider may need to drain the wound, cut away infected tissue, or prescribe antibiotics.
How to Prevent Foot Infections
Taking care of your feet is essential when you have diabetes. To protect yourself from infection, you should:
Wash, dry, and examine your feet thoroughly every day. Check your feet for any signs of injury, even small ones like redness, blisters, and cuts.
Wear comfortable shoes and socks and don’t go barefoot. You’ll reduce your chance for blisters or other injuries.
Trim your toenails straight across. Well-trimmed nails can prevent cuts. Use a nail file to smooth out sharp edges, too.
Never remove corns or calluses at home. See your doctor or a podiatrist for help to reduce the risk for injury.
See your doctor regularly. Reach out at the first sign of a foot injury so it can be treated promptly. And get your feet checked by a podiatrist at least once a year.
Diabetes can raise your risk of a urinary tract infection (UTI). That’s because excess glucose in your urine can create an environment that makes it easier for infection-causing bacteria to grow, says Michelle Routhenstein, RD, CDCES, a certified diabetes educator and registered dietitian in New York City.
UTIs can develop in your bladder, ureters, or urethra. Routhenstein says when left untreated, the infection can spread to your kidneys, which can be life-threatening in people with diabetes. It’s important to pay attention to possible symptoms like those below and seek treatment early:
Cloudy or bloody urine
Foul-smelling urine
Pain or burning when you urinate
Low-grade fever
Pressure or cramping in your lower abdomen or back
Frequent urge to urinate, even after you use the bathroom
Mild bladder infections are typically treated with antibiotics. The type you’ll need will depend on your infection and its severity. You can also support your UTI treatment at home by drinking plenty of water and using a heating pad for abdominal or pelvic pain.
Stay hydrated. Drinking enough water dilutes bacteria in your urine and helps flush bacteria out.
Urinate often. Holding it in gives infection-causing bacteria more time to grow.
Practice good hygiene. Wipe from front to back, take showers instead of long baths, use tampons instead of pads, and pee after sex. All these things can help keep harmful bacteria out of your urinary tract.
Wear breathable underwear. Breathable cotton is the name of the game. It helps reduce sweating, which in turn reduces harmful bacteria growth.
Eat probiotic-rich foods. Think plain yogurt, miso soup, or fermented pickles. They help bolster your body’s community of good bacteria, which can help keep bad bacteria growth in check.
Your skin is home to a vast number of nerves and blood vessels, and both can be damaged by high blood sugar.
“That, in turn, can raise your risk of bacterial or fungal skin infections,” Routhenstein says.
Bacterial infections, including cellulitis, impetigo, and carbuncles, are often the result of coming into contact with staphylococcus or streptococcus germs. They can cause redness, swelling, pain, and tenderness around the infected area. Fungal infections like jock itch, athlete’s foot, and ringworm are more likely to form around warm, moist skin folds. They tend to cause red, itchy rashes that might appear scaly or blistered.
As with other infections, early treatment can help keep the problem from turning serious and make your skin feel more comfortable. Bacterial infections are typically treated with topical or oral antibiotics. Antifungal medications are needed for fungal infections; the type your doctor recommends depends on your specific infection and how severe it is.
How to Prevent Skin Infections
Doubling down on some basic hygiene habits can help lower your skin infection risk.
Wash your hands regularly with soap and water.
Wash cuts with soap and water.
Let your doctor know if you have signs of a possible skin infection.
Women with diabetes are more likely to develop vaginal yeast infections, which are fungal infections caused by the yeast Candida albicans. SGLT2 inhibitors that are used to treat type 2 diabetes, such as dapagliflozin (Farziga) and empagliflozin (Jardiance) can also increase the risk of yeast and other genital infections.
These fungi normally live in and on our bodies in small amounts. But high blood sugar can make it easier for Candida to grow out of control and cause an infection.
“Elevated glucose creates a moist, sugar-rich environment that promotes yeast growth,” Routhenstein says.
If you have a yeast infection, you might notice symptoms around your vulva such as:
Itching and irritation
Burning, especially during urination or sex
Pain or soreness
Redness and swelling
Cottage cheese–like discharge
The earlier you begin to treat a yeast infection, the more effective the treatment is likely to be. If an infection doesn’t get better with over-the-counter treatments, or if it keeps coming back, it’s definitely time to see a doctor, who will be able to recommend and prescribe more powerful antifungal agents.
Don’t use scented tampons, scented pads, or feminine deodorants.
Avoid douching.
Change out of wet or sweaty underwear or bathing suits quickly.
Wear cotton underwear and loose-fitting bottoms.
Choose water-based sexual lubricants.
Diabetes can make you more prone to mouth and gum issues. As with other types of infections, high blood sugar can thwart healthy immune system functioning, reduce blood flow via damaged blood vessels, and provide more fuel for bacteria, all of which can lead to infections in your mouth.
Some of the most common infections include:
Gum disease: This harmful gum inflammation can make gums red, swollen, puffy, and prone to bleeding. Gingivitis is a common and mild form of the disease, which can result in periodontitis, a more serious form of gum disease, as well as tooth loss.
Oral thrush: A fungal infection caused by candida overgrowth, oral thrush can cause dry mouth, discomfort, and white patches.
Dry mouth: Dry mouth isn’t an infection, but it increases your risk of them. It can make your mouth uncomfortable and lead to tooth decay and fungal infections over time.
There are different treatments for different types of tooth and gum issues, so it’s important to see your dentist if you have concerning symptoms. Together, you can come up with a treatment plan based on your specific infection.
How to Prevent Oral Infections
A good oral hygiene routine can help you keep your mouth, gums, and teeth as healthy as possible:
Brush your teeth twice daily with a fluoride toothpaste.
Clean between your teeth once daily with dental floss, a dental pick, or another device recommended by your dentist.
See your dentist regularly.
Drink fluoridated water. Fluoride protects your teeth.
Avoid smoking, or if you currently smoke, talk with your doctor about quitting.
Similar to how high blood sugar can increase the risk for fungal infections of the skin, it can also cause balanitis, or inflammation of the glans (or head) of the penis. The problem, which is often caused by a yeast infection, only affects uncircumcised men.
Balanitis isn’t serious, but it can be uncomfortable. The problem can make the head of the penis red or discolored, swollen, itchy, or painful. It can also cause a foul odor and white discharge under the foreskin. It’s important to seek treatment if you’re having symptoms. Depending on the type of infection you have, your provider may recommend an antifungal cream or antibiotics.
How to Prevent Penis Foreskin Infections
In addition to improved blood sugar control, lifestyle habits can reduce your risk of balanitis. You should bathe regularly, avoid harsh soaps, clean the area under your foreskin with warm water, and dry it completely. Always use a condom when having sex, since sexually transmitted infections can cause balanitis.
Infections can quickly turn serious when you have diabetes. Folsom recommends contacting your primary care provider right away anytime you’re having infection symptoms. Those include redness, swelling, pain, or discharge around the site of the infection, or body-wide symptoms like fever, vomiting, or severe fatigue.
People with diabetes have a higher risk of developing a variety of infections, since chronically high blood sugar levels can compromise immune system response.
Bacterial and fungal infections of the feet, skin, and mouth are more common in those with elevated blood glucose levels, as are urinary tract infections and yeast infections.
To prevent escalating symptoms of infection or further complications, prompt medical attention is essential whenever symptoms of an infection are present, such as redness, pain, fever, or severe fatigue.
