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People with diabetes are more adversely affected when they get an infection than someone without the disease, because theyhave weakened immune defenses in diabetes. Some types of infection occur more frequently in patients with diabetes. This increased risk is largely attributable to an altered immune response due to chronic hyperglycaemia, but increased susceptibility to infection may also result from diabetic complications such as diabetic neuropathy and vascular insufficiency. Risk of most common infections is only modestly increased (e.g. 1.2 fold), but a number of rare but potentially fatal infections occur primarily or even almost exclusively in patients with diabetes. These include mucormycosis, emphysematous urinary tract infections, emphysematous cholecystitis, necrotizing fasciitis and malignant otitis externa. When you have diabetes, you are especially prone to foot infections, yeast infections, urinary tract infections and surgical site infections.Your insulin injection site can be a possible infection source. Injections provide a potential gateway for certain immune-suppressing agents to enter the blood. Immediate antimicrobial and/or surgical treatment is needed to prevent serious complications from these infections. In general, antimicrobial treatment of infections in patients with diabetes is not different than in patients without diabetes. Glucose lowering therapy often needs to be increased to counter the loss of control associated with infection. Vaccinations against influenza and pneumococcal infections are recommended for patients with diabetes. People with diabetes are reported to experience 21% more infections than the general population. Even so, it seems clear that the risk of many common infections increases in proportion to hyperglycemia. Special problems may also arise in relations to diabetic nephropathy, which may undermine host defences against infection, and peripheral vascular disease which may impair tissue nutrition, oxygen supply and the ability to mount an effective immune response. Peripheral neuropathy also increases the risk for diabetic foot infections. Hyperglycemia may compromise the immune system. Ex-vivo experiments, in which human cells are analysed in a laboratory environment outside of the body, show that innate cellular immunity may be compromised in hyperglycemic conditions. In a hyperglycemic or acidic environment neutrophils and macrophages malfunction, and restoring normoglycemia and a normal pH reverses these abnormalities.The adaptive cellular immune system may also be compromised, but evidence is sparse. T-cell function may be compromised, especially in hyperglycemic conditions. There is no evidence that the humoral adaptive immune system functions differently in patients with diabetes: this is illustrated by the fact that the antibody response to vaccinations seems to be as effective as in healthy controls.

People with diabetes are more adversely affected when they get an infection than someone without the disease, because theyhave weakened immune defenses in diabetes. Some types of infection occur more frequently in patients with diabetes. This increased risk is largely attributable to an altered immune response due to chronic hyperglycaemia, but increased susceptibility to infection may also result from diabetic complications such as diabetic neuropathy and vascular insufficiency. Risk of most common infections is only modestly increased (e.g. 1.2 fold), but a number of rare but potentially fatal infections occur primarily or even almost exclusively in patients with diabetes. These include mucormycosis, emphysematous urinary tract infections, emphysematous cholecystitis, necrotizing fasciitis and malignant otitis externa. When you have diabetes, you are especially prone to foot infections, yeast infections, urinary tract infections and surgical site infections.Your insulin injection site can be a possible infection source. Injections provide a potential gateway for certain immune-suppressing agents to enter the blood. Immediate antimicrobial and/or surgical treatment is needed to prevent serious complications from these infections. In general, antimicrobial treatment of infections in patients with diabetes is not different than in patients without diabetes. Glucose lowering therapy often needs to be increased to counter the loss of control associated with infection. Vaccinations against influenza and pneumococcal infections are recommended for patients with diabetes. People with diabetes are reported to experience 21% more infections than the general population. Even so, it seems clear that the risk of many common infections increases in proportion to hyperglycemia. Special problems may also arise in relations to diabetic nephropathy, which may undermine host defences against infection, and peripheral vascular disease which may impair tissue nutrition, oxygen supply and the ability to mount an effective immune response. Peripheral neuropathy also increases the risk for diabetic foot infections. Hyperglycemia may compromise the immune system. Ex-vivo experiments, in which human cells are analysed in a laboratory environment outside of the body, show that innate cellular immunity may be compromised in hyperglycemic conditions. In a hyperglycemic or acidic environment neutrophils and macrophages malfunction, and restoring normoglycemia and a normal pH reverses these abnormalities.The adaptive cellular immune system may also be compromised, but evidence is sparse. T-cell function may be compromised, especially in hyperglycemic conditions. There is no evidence that the humoral adaptive immune system functions differently in patients with diabetes: this is illustrated by the fact that the antibody response to vaccinations seems to be as effective as in healthy controls.