SUSCEPTIBILITY TO INFECTIONS IN DIABETES - METABOLIC EFFECTS

Diabetic patients suffer from recurrent episodes of infections. The ce llular and the humoral elements of the defense system against germ inv asion are disturbed by the diabetic metabolism. Neuropathy and vascula r damage promote the development of wounds and inhibit their healing. Altered motility of the gastrointestinal and the urinary tract lead to increased penetration of bacteria even there. Rare bacteria, atypical courses and frequent complications of infections result in delayed di agnosis and therapy. Dehydration, electrolyte disturbances, malnutriti on, and reduced general conditions even increase susceptibility to an infection. On the other hand, an infection deteriorates the metabolic situation in diabetes, resulting in the need for higher insulin doses, or insulin injections in patients normally on oral medication. Altere d every-day-life with modified food intake and reduced physical activi ty complicate diabetes therapy. Neuropathy, angiopathy, retinopathy, n ephropathy and other diabetic complications can be triggered and aggra vated during the course of an infection. To disrupt this vitious circl e of hyperglycemia enforcing infections, which then raise blood glucos e, it is necessary to know about the characteristic features of the in teractions of diabetes and infection.