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Why urinary tract infection occurs commonly in diabetics?

By Apollo 24/7, Published on- 19 December 2020

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Diabetes is a chronic disease where the blood sugar in the body sometimes increases to alarming levels. It can occur either due to lack of insulin release in the body or its inability to absorb the insulin produced by the pancreas. Diabetes can also trigger the development of various other illnesses like cardiovascular complications, nerve damage, kidney issues, vision problems and various skin conditions. Other from these, people with diabetes are also prone to getting frequent urinary tract infections (UTI) that can severely affect their kidneys, ureters, urinary bladder and urethra.

What is urinary tract infection (UTI)?

As the name suggests, urinary traction infection is a common type of bacterial infection that affects the urinary system. The infection can either affect the entire urinary tract or a single organ present in the tract:
  • If the infection is in the urinary bladder, it is called cystitis.
  • If the infection is in the urethra (the tube-like part that allows urine to pass out of the body), it is called urethritis.
  • If the infection reaches the kidneys, it is called pyelonephritis.
UTIs can occur to anyone, but they are more commonly seen in women as their urethra is shorter than that in men, which allows bacteria (like E. coli) from the anus to enter the urinary tract easily.
Older adults are also at higher risk of developing urinary tract infections due to their inability to empty the bladder completely. People with other medical conditions such as enlarged prostate, prolapsed bladder (urinary bladder slips out of its normal position), and diabetes are also at an increased risk of getting a UTI.

Why are diabetics prone to urinary tract infections?

In a study published in the journal Hindawi, scientists analyzed the urine samples of 772 patients and found that women and old aged adults with uncontrolled diabetes are at higher risk of developing urinary tract infections. Various studies have concluded that there are certain factors that can be responsible for frequent UTIs in diabetics. These include:
  • A higher concentration of glucose in the urine allows the disease-causing bacteria to grow.
  • High glucose levels in the renal parenchyma (a part of the kidney) provide a favourable environment for the multiplication of microorganisms, which ultimately results in the kidney getting infected.
  • Impairment of different types of immunity (humoral, cellular and innate immunity) in diabetics allows the disease-causing bacteria to cause infection.
  • Nerve damage (neuropathy) in the urinary tract of diabetics can result in urinary retention and inability to urinate properly, thus resulting in reduced bacterial clearance and increased chances of infection. Studies reveal 26% to 85% of diabetic women develop bladder dysfunction due to diabetic neuropathy.

What are the signs of urinary tract infection in diabetics?

The symptoms experienced during a lower urinary tract infection (where the urinary bladder and urethra are affected) include:
  • Constant feeling of the need to urinate
  • Pain or burning sensation while urinating
  • Foul-smelling urine
  • Cloudy urine
  • Pain in the abdomen and the back
  • Blood in the urine
The signs experienced during an upper urinary tract infection (where the kidneys and ureters are affected) include:
  • Diarrhoea
  • High fever
  • Chills
  • Vomiting
  • Pain in the back and side (flank)

How can urinary tract infections be prevented?

Urinary tract infections can be prevented easily by taking care of certain things:
  • Maintain normal blood sugar level as too much glucose (sugar) in the urine would encourage bacterial growth in the urinary tract.
  • Try and keep the genital area clean and dry. Do not use a scented soap or intimate wash products as they can irritate the genital region.
  • Carefully clean and wipe the genital area from front to back after urinating or passing stool.
  • Drink plenty of water so that any bacteria in the tract gets flushed on passing the urine.
  • Wash the genitals with water (especially women), before and after sexual intercourse.
  • Urinate after sexual intercourse.
  • Do not hold the urine.
  • Do not rush to empty the bladder while urinating.
  • Wear cotton-based undergarments and avoid synthetic underwear.
  • Change adult diapers or pads immediately if they are soiled.
  • Avoid or limit alcoholic beverages as they can irritate and inflame the urinary bladder.

What can be done to treat urinary tract infections in diabetics?

Usually, UTI is caused due to bacteria such as Escherichia coli, Klebsiella spp., Enterobacter spp., and Enterococci. However, a study published in the journal Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy concluded that diabetic patients are more prone to get UTI from drug-resistant microorganisms. Therefore, a urine culture might be required to rule out the bacteria responsible for the infection and to determine the medication required to treat the infection.
A proper course of antibiotics would be required to get rid of the infection. Topical creams and ointments would be given along with oral antibiotics to relieve the symptoms of UTI. A medical doctor would be best placed to understand the infection caused and recommend a suitable treatment plan.

Takeaway

Urinary tract infections are frequently seen in diabetics due to the high glucose content in their urine and sometimes an impaired immune system. However, UTI can be easily prevented by following the basic hygiene steps recommended in this article. Alongside these, diabetics need to keep their blood sugar levels under control to prevent the growth of bacteria in the urinary tract.
For any queries related to diabetes, speak to an endocrinologist or a diabetologist.

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