Infections

Introduction

Hyperglycemia (glucose levels >11 mmol/L) directly impair immune function, so infections are more common in people with poorly controlled diabetes.

Infections can present atypically in patients with diabetes, so have a low threshold for investigating if your patient has unexplained symptoms:

Common infections in people with diabetes

How your patient can reduce their risk of infections

There are some simple things that improve immune function and reduce the risk of infections.

These include:

Regular hand washing.
Sleeping at least 7-8 hours at night.
Eating high-fibre and prebiotic foods eg. yoghurt, nuts, high-fibre vegetables, cheese.
Maintaining good glucose control – glucose levels less than 11 mmol/L.
Regular vaccinations eg. Fluvax every year, Pneumovax every 5 years.

Most likely infection	Suggested Investigations
Dental infection Sinusitis Urinary tract infection Pneumonia	Clinical examination of teeth, gums, pharynx, sinuses, ears Urine mcs Chest x-ray CT sinuses if clinically indicated

Most likely infection	Suggested Investigations
Pneumonia Gall bladder	Chest x-ray Abdominal ultrasound

Most likely infection	Suggested Investigations
Urinary tract infection Diverticular disease Pelvic infections	Urine mcs Abdominal ultrasound

Most likely infection	Suggested Investigations
Pneumonia Gall bladder infection	Chest x-ray Abdominal ultrasound

Most likely infection	Suggested Investigations
Urinary tract infection Diverticulitis	Urine mcs Abdominal ultrasound

Most likely infection	Suggested Investigations
Foot infection – skin or soft tissues Osteomyelitis (OM)	Plain films of foot Foot and leg ultrasound to exclude collection, assess vascular supply and exclude DVT MRI is the definitive test for OM

Most likely infection	Suggested Investigations
Bone infection (osteomyelitis)	Plain films of the foot Foot and leg ultrasound to exclude collection & assess vascular supply

Info for Medical Professionals