DIABETES

. Posted in SPECIAL PATIENTS

It is widely believed that people with type 1 or type 2 diabetes are more prone to infection than their nondiabetic peers. Infection undoubtedly impairs blood sugar level control. For people with diabetes, controlling blood sugar levels not only is important for controlling the illness but also is necessary for treating subsequent infections and their complications.

The presence of diabetes impairs several aspects of white blood cell function, including cell movement. These people are prone to bacterial and fungal sinusitis with a greater frequency than the general public. They tend to suffer from chronic sinus infections and chronic pulmonary infections along with various other infections of other parts of their

body. It is always harder to control recurrent sinus infections in diabetics.

I explain to my patients with diabetes that it is of paramount importance that they be followed closely and that immediate action be taken when these infections flare. Furthermore, it is extremely important that they be compliant and take care of themselves in between infection flare-ups. It is also important that they work closely with their endocrinologist to keep their diabetes under control. For it is when the diabetes is out of control that they are most prone to the worst infections.

Lastly, people with diabetes are also prone to unusual infections with rare organisms. Bacterial and fungal infections can be very serious and complicated. Both acute and chronic bacterial and fungal sinusitis can lead to complications requiring immediate medical and sometimes surgical treatment. For example, bacterial infections in diabetics can spread to the eye, causing periorbital cellulitis (swelling of the eye socket contents), development of an abscess with protrusion of the eye, visual change and potentially blindness, or any combination of these symptoms. A bacterial infection can spread to the brain, leading to meningitis or a brain abscess. These complications can also happen to people who are not diabetic, although they are much more likely to oc - j cur with diabetics or immunocompromised patients.

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