Diabetes increases your risk for bladder and other urinary tract infections.
Nearly 11 percent of American adults have diabetes, according to the Centers for Disease Control and Prevention. Diabetes is a strong risk factor for heart attacks, strokes and other cardiovascular diseases, and it is the leading cause of kidney failure, non-traumatic amputations and new cases of blindness among adults. An additional burden imposed by diabetes is an increased risk for infections, including cystitis, or bladder infection.
People with diabetes are susceptible to more frequent and more serious infections because several facets of their immune system are impaired. The complement system -- which consists of a group of proteins that enable early immune responses to infections -- is less efficient if you have diabetes. Your white blood cells, which secrete infection-fighting chemicals and destroy bacteria, are also less active. Specialized proteins, called antibodies, which are needed for recognizing and eliminating disease-causing germs, may also be damaged by high blood glucose levels.
Bacteria are the most common cause of cystitis in people with diabetes as well as those who don't have diabetes. Bacterial cystitis typically causes frequent urination, an urge to empty your bladder and burning when you urinate. Your urine may become cloudy or bloody. When promptly treated, oral antibiotics usually get rid of the bacterial cystitis. Bacterial cystitis is more likely to progress to a kidney infection in people with diabetes, according to a March 2012 review in the "Indian Journal of Endocrinology and Metabolism." A kidney infection is usually heralded by fever, chills, nausea and flank or abdominal pain.
In addition to bacterial cystitis and kidney infections, people with diabetes are more likely to develop emphysematous cystitis, which is characterized by the presence of gas within your bladder cavity and bladder wall. Emphysematous cystitis, which is caused by carbon dioxide-producing bacteria, such as E. coli, Proteus and Klebsiella, may require hospitalization, using a catheter and intravenous antibiotics.
People with diabetes -- especially women -- are frequently diagnosed with asymptomatic bacteriuria, which means they have bacteria in their urine without symptoms. While there is some controversy surrounding the proper treatment of this condition, many doctors choose to prescribe antibiotics to prevent the progression of asymptomatic bacteriuria to bacterial cystitis or a bacterial kidney infection.
Fungi are a less common cause of cystitis in people with diabetes. The most common culprit, Candida, may enter your bladder from your bowel or vagina, where it often coexists with other microorganisms. The symptoms of fungal cystitis resemble those of bacterial cystitis. Fungi within your bladder may group together to form "fungus balls," which can obstruct your urethra and prevent you from emptying your bladder. Fungal cystitis usually responds to oral antifungal medications, such as fluconazole (Diflucan). In severe or persistent cases, bladder irrigation with antifungal medications may be required.
Diabetes Control Crucial
In addition to an impaired immune response, other factors increase the risk for cystitis in people with diabetes. If you have any urinary tract abnormalities, such as a prolapsed bladder or enlarged prostate, infections are more likely to gain a foothold. Women with recurrent vaginal infections are also more apt to develop cystitis. Notably, people with diabetes with high blood glucose levels tend to get cystitis more frequently than their counterparts whose blood glucose is well controlled. Your doctor can help you manage your diabetes and reduce your risk for urinary tract infections.
If you have symptoms of cystitis, contact your doctor right away. Early diagnosis and treatment are important to prevent the development of a more serious infection and possible complications.