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Yeast Infections With Diabetes

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Updated May 27, 2014

How Do Yeast Infections Occur?

Candida, or yeast, often lives on the human body as part of the body’s normal bacteria and organisms. When a change occurs, such as a shift in the body’s acidity from infection, condom use, antibiotics or diabetes, the balance of organisms is disrupted. Candida cells multiply unchecked, resulting in a yeast infection.

Why Are Women With Diabetes Prone to Vaginal Yeast Infections?

While most women will experience at least one yeast infection during the course of their lives, those with diabetes are especially susceptible. Yeast cells that normally live in the vagina are kept in careful check by the minimal available nutrients in the acidic environment of the vagina. In women with diabetes, vaginal secretions contain more glucose, or sugar, due to higher amounts of glucose in the blood. Yeast cells are nourished by this excess glucose, causing them to multiply and become a yeast infection. Also, hyperglycemia interferes with the immune functions that help prevent yeast infections. Yeast infections in women with diabetes can mean that blood glucose levels are not well-controlled or that an infection is brewing in another part of the body.

What Are the Symptoms of a Vaginal Yeast Infection?

Yeast infections often cause itching or discomfort around the vagina, white secretions resembling cottage cheese, foul odor and pain with urination or sexual intercourse. Some women, however, do not notice any symptoms with a vaginal yeast infection. Yeast infections can also occur in other locations, such as moist areas of the feet or skin folds, a dialysis access site or the mouth (thrush). Any yeast infection can cause discomfort and possibly result in a more serious infection.

How Is a Yeast Infection Diagnosed?

An examination is done if symptoms are due to a yeast infection and not another source, such as a bacterial infection or sexually transmitted disease. A microscope may be used to look at a cell sample to confirm the presence of yeast. Occasionally, further laboratory tests may be needed in order to confirm a yeast infection.

How Can a Yeast Infection Affect Diabetes?

The presence of yeast in the vagina or other areas blocks the body’s natural defense mechanisms against infection. When a woman with diabetes has a yeast infection, she is more likely to get other infections as well. This is because the combination of yeast and high blood sugar inhibits the body’s ability to fight off other bacteria and viruses. Any infection in a person with diabetes poses a risk because blood sugars may be much higher or lower than normal while the body tries to fight infection.

What Are the Treatment Options?

Antifungal medications, available over the counter and by prescription, effectively treat yeast infections in people with diabetes. A health care professional should be consulted before starting any new medications because oral antifungals can interact with regular medications. Some people may prefer to use a vaginal medication. Experts suggest that yeast infections occurring in women with diabetes may require up to two weeks of treatment. Other topical or oral antifungal agents, such as nystatin, are available by prescription to treat yeast infections in areas other than the vagina.

The most important thing to remember when treating a yeast infection, especially for people with diabetes, is for them to take the full amount of medication recommended by their health care providers. When medications are stopped early, because the person feels better, the infection can return and be even stronger than before.

What Questions Should Be Asked?

Once a diagnosis is confirmed, women should ask their health care providers for treatment recommendations. For example, whether they should use a vaginal cream or if oral medications would help. People who experience four or more yeast infections per year should ask their health care providers to check that their diabetes is under control and not causing the yeast infections because of overly high blood sugar.

Sources:

"Vaginal Yeast Infections: Transmission." Health and Science Topics. 29 Aug 2006. National Institute of Allergy and Infectious Diseases. 30 Aug 2007 <http://www3.niaid.nih.gov/healthscience/healthtopics/vaginitis/yeast/transmission.htm>.

Weintrob, Amy C., Sexton, Daniel J. “Susceptibility to infections in persons with diabetes mellitus.” UpToDate Online (4 Aug 2006). UpToDate 30 Aug 2007 (subscription) <http://www.utdol.com/utd/content/topic.do?topicKey=othr_inf/21673&selectedTitle=3~1696&source=search_result>

Sobel, Jack D. “Candida vulvovaginitis.” UpToDate Online (11May 2007). UpToDate 30 Aug 2007 (subscription) <http://www.utdol.com/utd/content/topic.do?topicKey=gen_gyne/27679&selectedTitle=45~4125&source=search_result>

Kauffman, Carol A. “Overview of candida infections.” UpToDate Online (6 March 2007). UpToDate 30 Aug 2007 (subscription) < http://www.utdol.com/utd/content/topic.do?topicKey=fung_inf/10432&selectedTitle=96~4125&source=search_result>

Kauffman,Carol A. "Treatment of oropharyngeal and esophageal candidiasis." UpToDate. CD-ROM.15.2 ed.UpToDate,2007.

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