Urinary tract infections, which are infections of the urethra, bladder, ureters or kidneys, are a health problem that affects millions of people each year. Certain populations of people, including women and people with diabetes are at increased risk of developing this type of infection. If you have diabetes, you are also at increased risk of having difficulty treating the infection once it does occur.
Background
Urine typically does not contain bacteria, viruses or fungi. A bladder infection often begins when bacteria from the digestive tract enters the urinary tract and multiplies. From there, the bacteria can travel from the urethra to the bladder and even to the kidney. The flow of urine helps to flush bacteria back out of the urinary tract, but diabetes changes the immune system and allows bacteria to multiply more easily. If you are a woman with diabetes, your risk increases even more because the proximity of the urethral opening to the anus increases the probability that bacteria from the digestive tract will enter the urinary tract.
Diagnosis
Symptoms of a urinary tract infection include a strong urge to urinate, burning with urination, cloudy urine, strong smelling urine and abdominal pain. When the infection has spread to your bladder, you may also see blood in your urine. If you have diabetes, a urinalysis and culture will be sent to determine the specific bacteria that is causing your infection. While the most common type of bacteria to cause a bladder infection is called escherichia coli, the immune system suppression of diabetes increases your risk of infection from less common bacteria.
Treatment
Bladder infections can be more severe in diabetic people than in people without other health problems, likely because a depressed immune system makes fighting infection more difficult. For this reason, antibiotics, or medications that kill bacteria, are often needed for a longer period of time if you are diabetic. While most people only need to take an antibiotic for a few days, you may need to take one for seven to 10 days. Examples of antibiotics that may be used include amoxicillin, nitrofurantoin, ciprofloxacin and levofloxacin. The type of antibiotic chosen depends on the type of bacteria causing your infection. If the infection has spread to your kidneys, you may need to stay in the hospital and receive antibiotics intravenously.
Prevention
The best way to prevent a urinary tract infection if you are diabetic is to reduce your risk by keeping your blood glucose under control. Your physician likely requires that you adhere to a specific diet and take medication to help with this and you should check your blood sugar levels as she directs. Drinking adequate water, urinating regularly, taking showers instead of baths and wiping front to back if you are a woman are all ways to help reduce your risk of urinary tract infections.
