Diabetes and Yeast Infections - 5 Things Every Diabetic Should Know

As a result of high blood sugar levels and immune system dysfunction, diabetics are prone to more frequent and more serious infections than non-diabetic persons. Among these infections, yeast ranks among the most common and in fact sometimes leads to the diagnosis of diabetes.

Is this dangerous? Is there anything a person can do about the situation?

Here are 5 things every diabetic should know about yeast infections:

1. Vaginal yeast infections - don't skip this one men - there are some things here you need to know, too.

Yeast thrive in a warm, moist environment, especially when there's plenty of food, i.e. excess sugar. There are always a few yeast in the neighborhood, but other "good" germs normally crowd them out. In diabetes, the yeast may grow in abundance and become like crabgrass: once it takes hold, it's hard to eliminate. If you have never been diagnosed with diabetes but have been getting more than your share of yeast infections, or have had trouble being cured of a yeast infection, consult your doctor - you may be diabetic.

Usually yeast is not a sexually transmitted disease, but in a diabetic it can be, especially if both partners are diabetic. Other STDs may be more easily transmitted as well if fragile tissues are already irritated from a yeast infection. Women who are suffering from vaginal itching and burning are also less likely to be interested in intercourse. Because the symptoms of yeast infections, urine infections, and STDs overlap women sometimes mistake one for the other.

If you are diabetic and suffering from prolonged or recurrent yeast infections you should talk to your doctor. You may need to control your blood sugars more effectively. You may need a prolonged course of anti-yeast medication. You may need a combination of oral and topical medications. You may need to be checked for another type of infection that mimics yeast.

2. Thrush (oral yeast infection). Yeast infection in the mouth is common in diabetics who don't have their blood sugars well controlled, especially in patients with dentures. Thrush has a variety of presentations. Often it appears as white spots that coat the inside of the cheeks or the tongue. Sometimes the mouth looks raw or irritated. Other people complain of a change in taste or sore feeling even though the tissues appear normal. Oral thrush indicates a need for better sugar control, better oral hygiene, or both. It may require oral medication, topical medication, or both, and may occur at the same time as a yeast infection elsewhere in the body.

3. Intertrigo (yeast infections in warm skin folds). Intertrigo is especially common in men and women who have folds of overlapping skin that remain moist. Common areas include the axilla (armpit), groin, under the breast, and under the belly. Intertrigo appears as a red or pink rash, usually flat (not bumpy), that is often moist, and may have an unpleasant odor or itching. Again the cure lies in controlling blood sugars, keeping the area dry, and medication. Topical creams such as Lotrimin or Lamisil are effective. If itching is prominent, OTC hydrocortisone may be added. Wearing a cotton T-shirt or underwear helps keep the area dry.

4. Antibiotic-related yeast infections. Diabetics who take antibiotics for respiratory or other infections are at high risk of developing any of the above conditions. The antibiotics kill off many normal germs (normal flora), and allow yeast to take hold. A yeast infection may show up while a patient is taking the antibiotic or up to a few weeks later. Those who take daily antibiotics for conditions such as acne or rosacea are especially at risk. The key to prevention is minimizing antibiotic exposure. Don't request an antibiotic for a cold you've only had a few days. If you must continue an antibiotic for some reason, you may need to take a prolonged course of anti-yeast medication as well. One approach for diabetics who tend to get yeast infections is to begin a yeast medication prophylactically as soon as an antibiotic is begun. Ask your doctor what the best plan is for you.

5. Steroid-related yeast infections. It's not uncommon for a diabetic patient to suffer a separate condition (such as arthritis or asthma) for which steroid medications are prescribed. Steroids alone predispose to yeast infections, but doubly so in a diabetic, since they may raise blood sugar levels. Steroid pills, IVs, injections, and inhalers all predispose to yeast infections. If you use a steroid inhaler, make sure you follow the directions about rinsing your mouth afterward. If you receive an injection in your knee for arthritis, be aware that elevated blood sugar readings and thrush may follow. For persons taking steroids on a prolonged basis, daily yeast medication may be required.

It's rare that a yeast infection would be more serious than the situations described above. If you're diabetic and having trouble with recurrent or prolonged infections, ask your doctor if there are any special measures you should take. If your blood sugar isn't controlled, develop a plan with your physician to take control of the situation.
Copyright 2010 Cynthia J. Koelker, MD


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Permission is hereby granted to publish this copyrighted article elsewhere on the web or in print media, in whole or in part, with the stipulation that Dr. Koelker be properly credited as author, and that the material be unaltered with regard to content.
Cynthia J. Koelker, MD is a family physician of over twenty years, and holds degrees from MIT, Case Western Reserve University School of Medicine, and the University of Akron. She is the author of "101 Ways to Save Money on Healthcare."