Infections and blood sugar

Infections

Diabetes can have a profound effect on how the body functions, especially if blood sugar remains uncontrolled. Uncontrolled blood sugar promotes cardiovascular disease (atherosclerosis, heart disease), cerebrovascular disease (stroke), and peripheral vascular disease, as well as damage to the kidney and damages the nerves. In addition, uncontrolled blood sugar can change the immune system function, making the body less able to fight infection. All of these negative health effects can work together to interfere with the body’s ability to fight infection effectively and even interfere with our ability to detect the signs of an infection.1

For this reason, people with uncontrolled diabetes tend to develop infections more commonly and these infections tend to be more severe. The main types of infections that occur in people with diabetes include2 :

  • Foot infections
  • Urinary tract infections
  • Fungal infections (affecting the mouth, skin and nails)
  • Bacterial infections of the skin and soft tissues
  • Influenza and pneumonia

How does type 2 diabetes increase risk of infections?

Diabetes with uncontrolled blood glucose can interfere with how your immune system works, rendering it less able to protect against infection. Our immune system is made up of many different cells and chemicals whose job it is to fight invasion or infection by foreign substances or organisms, such as viruses and bacteria. The most important cells involved in the immune system are white blood cells. There are several types of white blood cells, each with a specific role to play in fighting infection. High blood sugar can make white blood cells less able to kill and dispose of organisms that invade the body. Additionally, when the body is trying to fight off an infection, it experiences an increase in stress, which causes the production of a number of different hormones, including cortisol and glucagon, which trigger release of glucose from the liver, making glucose levels rise significantly. 2,3

How can I lower my risk of getting an infection?

If you have uncontrolled diabetes, you are at increased risk for a range of infections. However, there are several simple, practical steps that you can take to protect yourself against the development of infections. These include:

You and your family and friends should practice good hygiene

Wash your hands frequently and covering your mouth when you cough or sneeze.

Keep your blood glucose under control

Elevated blood glucose is associated with immune system impairment (as well as many other complications of diabetes). So, to protect against infection and other health problems, you should make a point of keeping your blood glucose under control.

Get vaccinated

Getting an influenza vaccine (unless you are allergic to the vaccine) every year is a good way to avoid contracting the flu, or, if you get the flu, making sure it is less severe. There are several other vaccines that you can get to protect against other infections, including shingles and pneumococcal pneumonia. For instance, the US Centers for Disease Control and Prevention (CDC) recommends that all adults 60 years of age and older should get a shingles vaccine and that all children (from age 2 years and up) and adults with diabetes should get a pneumococcal pneumonia vaccine. You can learn more about CDC recommendations for vaccinations at the CDC website. Talk to your doctor about whether you might benefit from these vaccines.

Make healthy lifestyle changes

You can reduce your risk of infection by being as healthy as you can. This includes quitting smoking (if you smoke), losing excess weight and keeping it off, keeping your blood pressure and lipids under control, getting regular exercise of moderate intensity, and adopting an energy-appropriate and nutrient-dense eating pattern. A healthy eating pattern should be based on recommendations for the general public in the US Department of Agriculture’s Dietary Guidelines for American, 2010 and should include a high intake of fruits, vegetables, and dietary fiber and a low intake of total fat, saturated fat, and added sugars.

Infections of the foot

People with uncontrolled diabetes are at higher risk for developing foot infections, both because of impaired immune system function and because nerve damage (neuropathy) can lead to loss of sensation, increasing risk for undetected injury. Additionally, peripheral vascular disease (also called peripheral artery disease ), in which arteries that supply the feet become clogged, cuts the supply of blood to the feet, making wound healing slower and the delivery of antibiotics to the feet more difficult.

Treatment for foot infections depends on the seriousness of the infection and typically involves use of antibiotics (oral or intravenous). While your foot is infected, it is very important to keep pressure off the wound so that it can heal properly. This may require bed rest or the use of a wheelchair or crutches or custom footwear. Additionally, removal of infected and dead tissue may be necessary. Without proper treatment, foot infections can progress to the point where amputation is necessary. So, if you develop a foot infection, it is very important to get help immediately and if you have diabetic neuropathy that affects your feet, you should get in the habit of checking your feet on a daily basis.3

Infections of the urinary tract

Infections of the urinary tract, including the bladder and the kidney, are more common in people with diabetes.

Bladder infection

Bladder infection (also called cystitis) is associated with signs and symptoms. These include an increased need to urinate more frequently and pain and burning during urination. Urine may also have blood in it and may be cloudy with an unpleasant odor. A person with cystitis may also experience pain in the area over the bladder and fever. The standard treatment for cystitis caused by a bacterial infection is a course of antibiotics for 3 to 7 days. Bladder infections can sometimes be caused by fungus (people with uncontrolled diabetes are at higher risk for this kind of bladder infection). A fungal infection requires treatment with an antifungal medication. Fungal infections of the urinary tract may also be associated with the growth of a large mass of fungus, which may require surgery to remove.3

Kidney infection

Infection of the kidney (also called pyelonephritis) occurs when bacteria migrate up the tubes (the ureters) that connect the kidney with the bladder. This type of infection can occur at the same time as a bladder infection or develop afterward. Pyelonephritis is associated with symptoms including nausea, vomiting, fever, chills, and severe pain affecting the side or upper back. If a kidney infection is not severe, it can be treated with a course of antibiotics or an antifungal medication (depending on the organism causing the infection) at home. However, if symptoms are severe, intravenous antibiotic treatment may require a short hospitalization.3

In rare cases, a more serious type of kidney infection called emphysematous pyelonephritis may develop. This condition is characterized by the presence of gas in the kidneys, produced by bacteria or fungi from high blood glucose levels in the tissue of the kidney. Emphysematous pyelonephritis is an extremely dangerous condition that requires immediate hospitalization.3

Infections of the skin and nails

Diabetes is associated with increased risk for several infections of the skin and nails, including onychomycosis, tinea pedis, and cellulitis.3

Onychomycosis

Onychomycosis is a fungal infection that affects the fingernails or toenails, resulting in thickened, yellowed nails that can lift or separate from the skin beneath. This fungal infection is typically treated with oral (systemic) or topical antifungal medication.

Tinea pedis

Tinea is a fungal infection that affects the skin between the toes, resulting in cracking and itching of the skin of the toe web. It is typically treated with a topical antifungal medication.

Cellulitis

Cellulitis is the term used for any bacterial infection of the skin and underlying tissues. The typical signs and symptoms of cellulitis include painful, swollen, red skin (sometimes with blistering). It may also include a fever. Treatment for cellulitis typically includes antibiotics. It may also involve surgical removal of dead or infected tissue.

Other infections

Additionally, there are several infections that are rare and serious (usually requiring hospital care) and tend to occur almost exclusively in people with diabetes. These include:2,3

Malignant external otitis

This is a severe type of ear infection that can spread from the external ear canal to the soft tissue and, eventually, the bone next to the ear canal. It is most often seen men who are over the age of 65 years and have had diabetes for many years. Signs of this condition include severe painful earache with festering discharge from the ear. Treatment requires 6 weeks of antibiotics, with surgical removal of tissue necessary if the infection has progressed.

Rhinocerebral mucormycosis

An infection of the sinuses or palate of the mouth associated with ketoacidosis. The signs of this condition include pain in the area of the eyes or front of the face, with nasal discharge that is yellowish-white and may contain blood. The danger with rhinocerebral mucormycosis is the spread of infection to the brain. Treatment involves antibiotic or antifungal agent. Additionally, dead or infected tissue my need to be surgically removed.

Emphysematous cholecystitis

An infection of the gallbladder by gas-forming bacteria. Unless treated promptly, this dangerous condition may result in perforation of the gallbladder or gangrene. The chance of emphysematous cholecystitis being fatal is high, so rapid detection and treatment are important. Treatment typically requires removal of the gallbladder and antibiotic therapy.

Handling Diabetes When You’re Sick

  • Larger text sizeLarge text sizeRegular text size

For people with diabetes, being sick can affect blood sugar levels. The good news is that taking a few precautions can help you keep your blood sugar levels under control.

How Does Illness Affect Blood Sugar Levels?

When you get sick — whether it’s a minor illness like a cold or a bigger problem — the body sees the illness as stress. To deal with the stress, it releases hormones that increase sugar in the blood.

In one way, this is good because it helps supply the extra fuel the body needs. But in a person with diabetes, it can lead to blood sugar levels that are too high. Some illnesses cause the opposite problem. If you don’t feel like eating or have nausea or vomiting, and you’re taking the same amount of insulin you normally do, your blood sugar levels can get too low.

Blood sugar levels can be very unpredictable when you’re sick. Because you can’t be sure how the illness will affect them, it’s important to check blood sugar levels often on sick days and change your insulin doses as needed.

Planning for Sick Days

Your diabetes management plan will help you know what to do when you’re sick. The plan might tell you:

  • how to check your blood glucose levels and ketones when you’re sick
  • which medicines are OK to take
  • what changes you might make to your food and drink and diabetes medicines
  • when to call your doctor

Also, people with diabetes should get the pneumococcal vaccine, which protects against some serious infections. You also should get a flu vaccine every year. These vaccines may help cut down the number of sick days you have and keep your diabetes under better control.

What to Do When You’re Sick

Your doctor will give you specific advice when you’re sick. But here are some general guidelines:

  • Stay on track. Unless your doctor tells you to make a change, keep taking the same diabetes medicines. You need to keep taking insulin when you’re sick, even if you’re not eating as much as you usually do. That’s because your liver makes glucose and releases it into your blood — even when you’re stuck on the couch — so you always need insulin. Some people with diabetes need more insulin than usual on sick days. Even some people with type 2 diabetes who don’t usually take insulin may need some on sick days.
  • Check blood sugar and ketone levels often. Your doctor will tell you how often to check your blood sugar and ketone levels — usually you’ll need to check more often while you’re sick.
  • Pay special attention to nausea and vomiting. People with diabetes sometimes catch a bug that causes nausea or vomiting. But nausea and vomiting are also symptoms of ketoacidosis. If you feel sick to your stomach or are throwing up, it’s important to keep a close eye on your blood glucose and ketone levels and get medical help according to the guidelines in your diabetes management plan. The best approach is to stick to your insulin schedule, check ketones regularly, and follow your doctor’s advice about when to get help.
  • Prevent dehydration. Be sure to drink plenty of fluids, even if you have nausea or vomiting. Your doctor can recommend the types and amounts of fluids to drink that can help you manage both your illness and your blood sugar levels.
  • Use over-the-counter (OTC) medicines wisely. People sometimes take OTC medicines (the kind you can buy without a prescription) for illnesses like the cold or flu. But these have ingredients that can raise or lower blood sugar or cause symptoms that look like high or low blood sugar. Follow your doctor’s advice about taking an OTC medicine. Your doctor might even include common medicines that are OK for you in your diabetes management plan, and can also explain what to check for on medicine labels.
  • Take notes. Your doctor might have a lot of questions about your illness and your symptoms. So it can help if you write down your symptoms, medicines and doses, what food and drinks you had, and whether you kept the food down. Also, tell the doctor if you’ve lost weight or had a fever, and have your blood sugar and ketone level test results handy.
  • Get some rest. People need rest when they’re sick. It helps your body focus its energy on fighting illness. If you think you need to, let a parent take over managing your diabetes for a day or two. Your mom or dad can keep track of your blood sugar levels and figure out the best insulin dosage — and you can get some sleep!

When Should I Call the Doctor?

Your diabetes management plan will explain when you may need medical help and what to do. Here are some general reasons to call your doctor:

  • if you have no appetite or you can’t eat or drink
  • if your blood sugar level is low because you haven’t been eating much — but remember to take steps at home to bring your blood sugar back up
  • if you keep vomiting or having diarrhea
  • if your blood sugar levels are high for several checks or don’t decrease when you take extra insulin
  • if you have moderate or large amounts of ketones in the urine (or high levels of blood ketones if you have a meter that tests for this)
  • if you think you might have ketoacidosis
  • if you can’t eat or drink because you’re having a medical test like an X-ray, surgery, or a dental procedure

Any time you have questions or concerns, ask your doctor for advice.

Reviewed by: Larissa Hirsch, MD Date reviewed: September 2019

9 Dos and Don’ts of Managing Diabetes When You’re Sick

Thinkstock

Sign up for more FREE Everyday Health newsletters.

Type 2 diabetes doesn’t take a day off — even if you’re feeling lousy because you have a cold or the flu. In fact, when you’re sick, you need to be extra mindful to stay on top of your diabetes self-care. That’s because a cold, sinus infection, or the flu can put your body under stress, causing it to release hormones that help fight the illness — but these hormones can also affect your blood sugar levels.

Infections, particularly serious ones, can lead to diabetes complications. The most dangerous — although it’s rare in people with type 2 diabetes — is diabetic ketoacidosis, which can lead to a diabetic coma, according to endocrinologist Alan Garber, MD, PhD, a professor of medicine in diabetes, endocrinology, and metabolism at the Baylor College of Medicine in Houston and president of the American College of Endocrinology. “Infection is a metabolic stress, and it raises your blood sugar,” Dr. Garber says. It can be hard to know how you will respond to each infection, he adds.

Being sick can also lead to dehydration, eating differently, oversleeping, and losing track of your schedule — all of which can make diabetes management harder.

However, there’s a proactive step you can take to prepare before your next cold or flu: Discuss a sick day plan with your doctor. According to the American Diabetes Association (ADA), this plan should outline the general steps you need to take when sick, such as:

  • How often you’ll need to test your blood sugar
  • What to do if your blood sugar gets high
  • When to test your ketones
  • What medications to take
  • What and how to eat
  • When to call your doctor

Put your plan in writing, include your doctor’s contact information, and make sure the plan is available to a loved one or friend in case you need help.

There are also many things you can do (or not do) to help keep your diabetes under control if you do get sick.

The Dos and Don’ts of Diabetes Care When You’re Sick

DO drink plenty of fluids. Fluids are recommended for anyone who’s sick because diarrhea and vomiting can cause dehydration. People with diabetes should be even more vigilant about drinking fluids because high blood sugar levels lead to more urination, adding to your risk for dehydration. Choose water or sugar-free sports drinks to replace electrolytes and fluids, Garber says.

DON’T skip or double up on medication doses. Garber stresses that you shouldn’t try to adjust your diabetes medication or insulin without your doctor’s advice. If it hasn’t already been outlined in your sick day plan, call your medical team to find out what to do if your blood sugar is unusually high or low.

DO check your blood sugar level regularly. When you’re sick, you’ll need to check your blood sugar more often. If blood sugar spikes over 300, the ADA recommends also checking ketones, which you can do with a urine test strip.

DO pick diabetes-friendly cold medications. The ADA recommends asking a pharmacist to help you when you’re looking for over-the-counter medicines, if your doctor hasn’t already recommended the best ones for you. Try to find sugar-free cough syrup and be aware that decongestants can affect both blood sugar levels and blood pressure.

DON’T ignore symptoms of potential diabetes emergencies. Your sick day plan should outline when to call your doctor, but some symptoms could signal a possible diabetes emergency. The ADA says these include:

  • Blood sugar levels that keep rising or are over 240
  • Moderate to large amounts of ketones in your urine
  • Frequent urination
  • Dry mouth or thirst
  • Vomiting for more than six hours
  • Abdominal pain
  • Confusion
  • Loss of consciousness

Even if you’re not experiencing these symptoms, call your doctor any time you aren’t sure about your medications or how to care for yourself.

DO eat small meals often. Stock up on foods that are easy for a sick stomach, such as soup, crackers, applesauce, and gelatin. “Chicken noodle soup can do people a world of good,” says Garber. The ADA recommends 50 grams of carbohydrates every three to four hours, and you should generally try to get your usual daily calorie intake. If you can’t eat any solids, try frozen fruit pops, broth, pudding, or juice.

DO keep a written record. Write down your blood sugar test results, the times you take medications, when you eat and what you eat, and any new symptoms you experience, such as vomiting, diarrhea, fever, or abdominal pain. The ADA also recommends tracking your weight if you’re sick for several days.

DO wear a medical ID. Most sick days will pass without trouble, but if you ever lose consciousness or need to go to the emergency room, a medical ID will give vital information to medical professionals.

DON’T isolate yourself. Although it may be tempting, Garber doesn’t recommend toughing it out alone. Going to the doctor could mean you get flu medications or antibiotics early in your illness, so don’t hesitate to make an appointment.

Take Care of Your Diabetes During Sick Days & Special Times

Diabetes is part of your life. You can learn how to take care of yourself and your diabetes when you’re sick, when you’re at school or work, when you’re away from home, when an emergency or a natural disaster happens, or when you’re thinking about having a baby or are pregnant.

When You’re Sick

Having a cold, the flu, or an infection can raise your blood glucose levels. Being sick puts stress on your body. Your body releases hormones to deal with the stress and to fight the sickness. Higher hormone levels can also cause high blood glucose levels. You should have a plan for managing your diabetes when you’re sick. The first step is to talk with your health care team and write down

  • how often to check your blood glucose levels
  • whether you should check for ketones in your blood or urine
  • whether you should change your usual dose of your diabetes medicines
  • what to eat and drink
  • when to call your doctor

People who are sick sometimes feel as though they can’t eat as much or can’t keep food down, which can cause low blood glucose levels. Consuming carbohydrate-rich drinks or snacks can help prevent low blood glucose.

If you are sick, your health care team may recommend the following:

  • Check your blood glucose levels at least four times a day and write down the results in your record book. Keep your results handy so you can report the results to your health care team.
  • Keep taking your diabetes medicines, even if you can’t eat.
  • Drink at least 1 cup, or 8 ounces, of water or other calorie-free, caffeine-free liquid every hour while you’re awake.
  • If you can’t eat your usual food, try eating or drinking any of the following to prevent low blood glucose levels:
    • juice
    • saltine crackers
    • dry toast
    • soup
    • broth or bouillon
    • ice pops or sherbet
    • gelatin that isn’t sugar-free
    • milk
    • yogurt
    • soda that isn’t sugar-free

Your doctor may ask that you call right away if

  • your blood glucose levels are above 240 even though you’ve taken your diabetes medicines
  • your urine or blood ketone levels are above normal
  • you vomit more than once
  • you have diarrhea for more than 6 hours
  • you have trouble breathing
  • you have a high fever
  • you can’t think clearly or you feel more drowsy than usual

You should call your doctor if you have questions about taking care of yourself.

When You’re at School or Work

Take care of your diabetes when you’re at school or at work:

  • Follow your healthy eating plan.
  • Take your medicines and check your blood glucose levels as usual.
  • Tell your teachers, friends, or close coworkers that you have diabetes and teach them about the signs of low blood glucose. You may need their help if your blood glucose levels drop too low.
  • Keep snacks nearby and carry some with you at all times to treat low blood glucose.
  • If you have trained diabetes staff at your school or work, tell them that you have diabetes.
  • Wear or carry an identification tag or card that says you have diabetes.

Tell your teachers, friends, or close coworkers about the signs of low blood glucose. You may need their help if your blood glucose levels drop too low.

When You’re Away from Home

These tips can help you when you’re away from home:

  • Get all your vaccines and immunizations, or shots, before you travel. Find out what shot you need for where you’re going, and make sure you get the right shots on time.
  • Follow your healthy eating plan as much as possible when you eat out. Always carry a snack with you in case you have to wait for a waiter to serve you.
  • Limit alcoholic beverages. Ask your health care team how many alcoholic beverages you can safely drink. Eat something when you drink to prevent low blood glucose.
  • If you’re taking a long trip by car, check your blood glucose levels before driving. Stop and check your blood glucose levels every 2 hours.
  • Always carry your diabetes medicines and supplies in the car where you can reach them in case your blood glucose levels drop too low.
  • In case you can’t leave for home on time, bring twice the amount of diabetes supplies and medicines you normally need.
  • Take comfortable, well-fitting shoes on vacation. You’ll probably be walking more than usual. Keep your medical insurance card, emergency phone numbers, and a first aid kit handy.
  • Wear or carry an identification tag or card that says you have diabetes.
  • If you’re going to be away for a long time, ask your doctor for a written prescription for your diabetes medicines and the name of a doctor in the place you’re going to visit.
  • Don’t count on buying extra supplies when you’re traveling, especially if you’re going to another country. Different countries use different kinds of diabetes medicines.

When You’re Flying on a Plane

These tips can help you when you’re flying on a plane:

  • Ask your health care team in advance how to adjust your medicines, especially your insulin, if you’re traveling across time zones.
  • Take a letter from your doctor stating you have diabetes. The letter should include a list of all the medical supplies and medicines you need on the plane. In the letter, the doctor should also include a list of any devices that shouldn’t go through an x-ray machine.
  • Carry your diabetes medicines and your blood testing supplies with you on the plane. Never put these items in your checked baggage.
  • Bring food for meals and snacks on the plane.
  • If you use an insulin pump, ask airport security to check the device by hand. X-ray machines can damage insulin pumps, whether the pump is on your body or in your luggage.
  • When on a plane, get up from your seat and walk around when possible.

Read more about planning for travel and travel safety if you have diabetes in Have Diabetes. Will Travel (319 KB) .

Bring food for meals and snacks on the plane.

When an Emergency or a Natural Disaster Happens

Everyone with diabetes should be prepared for emergencies and natural disasters, such as power outages or hurricanes. Always have a disaster kit ready. Include everything you need to take care of your diabetes, such as

  • a blood glucose meter, lancets, and testing strips
  • your diabetes medicines
  • insulin, syringes, and an insulated bag to keep insulin cool, if you take insulin
  • a glucagon kit if you take insulin or if recommended by your doctor
  • glucose tablets and other food or drinks to treat low blood glucose
  • antibiotic cream or ointment
  • a copy of your medical information, including a list of your conditions, medicines, and recent lab test results
  • a list of your prescription names with dosage information and prescription numbers from your pharmacy
  • phone numbers for the American Red Cross and other disaster relief groups

You also might want to include some food that doesn’t spoil, such as canned or dried food, along with bottled water. Read more about preparing for an emergency at the Centers for Disease Control and Prevention Emergency Preparedness and You website at www.emergency.cdc.gov/preparedness.

If You’re a Woman and Planning a Pregnancy

Keeping your blood glucose levels near normal before and during pregnancy helps protect both you and your baby. Even before you become pregnant, your blood glucose levels should be close to the normal range.

Your health care team can work with you to get your blood glucose levels under control before you try to get pregnant. If you’re already pregnant and you have diabetes, see your doctor right away. You can take steps to bring your blood glucose levels close to normal.

Your insulin needs may change when you’re pregnant. Your doctor may want you to take more insulin and check your blood glucose levels more often.

If you plan to have a baby,

  • work with your health care team to get your blood glucose levels as close to the normal range as possible
  • see a doctor who has experience taking care of pregnant women with diabetes
  • don’t smoke, drink alcoholic beverages, or use harmful drugs
  • follow your healthy eating plan

Be sure to have your eyes, heart and blood vessels, blood pressure, and kidneys checked. Your doctor should also check for nerve damage. Pregnancy can make some health problems worse.

More information about diabetes and pregnancy is provided in the NIDDK health topic, Diabetes and Pregnancy.

Your health care team can work with you to get your blood glucose levels under control before you try to get pregnant. If you’re already pregnant, see your doctor right away.

Sinus infections are typically caused by bacterial or viral infections. There are other, less common causes of sinus infections, such as dry eyes, that develop in conjunction with other medical conditions.This often leads to further questions, such as, “Can a sinus infection cause dry mouth?” With certain preexisting health conditions, sinus infection causes can become complicated. For example, diabetes and sinus infections can be linked if conditions are not well managed.

Diabetes and Sinus Infections

Did you know that diabetes and sinus infections can be related? High blood glucose levels from diabetes can also make you more susceptible to developing sinus infections. Some people, especially those who poorly manage their disease, can have higher risks of developing infections, including those of the skin, oral cavity, and sinuses.

However, the right mixture of treatment and control can lower the potential for diabetes and sinus infections occurring together. Maintaining tight control over your blood sugar levels will help mitigate this risk, while helping to reduce the risk for diabetes-related complications, such as renal failure, heart attack, and stroke.

Diabetics may be at a higher risk for developing yeast infections, such as oral candida, which can also spread to your nasal cavity, leading to a fungal sinus infection.

Candidiasis favors warm, moist environments such as the mouth and throat. Because diabetes can cause high concentrations of glucose to accumulate in your mouth, fungi and yeast microorganisms flourish because they thrive on sugar. Once you have good control over your diabetes, your risk for oral yeast infections will decrease, as will your risk for sinus infections.

Another way diabetics are more susceptible to sinus infections is that diabetes can suppress the immune system, raising the risk for opportunistic infections.

Autoimmune Disorders: Sinus Infections and Dry Eyes

Autoimmune disorders can present complex difficulties outside of core disease areas. For example, sinus infections can stem from dry eyes that are the result of dry mouth and an autoimmune disorder. Consider Sjögren’s syndrome, can cause damage to the salivary glands. When this happens, salivary flow to the mouth is diminished, leading to dry mouth.

Saliva is needed to wash away oral bacteria, and when salivary flow is inhibited, microorganisms can build up in the mouth, leading to an infection that can spread to the sinuses.

In addition to salivary gland dysfunction, Sjögren’s syndrome also causes extremely dry eyes because it not only affects your tear glands, but it also diminishes the amount and quality of tears you produce.

Many people believe that tears are solely comprised of water and saline. Tears, however, contain a rich network of nutrients and lubricants to help keep your eyes moisturized and healthy.

Extremely dry eyes can also heighten your risk for infection, which can spread to your nasal cavity, subsequently causing a sinus infection.

If you have an autoimmune disorder that causes a dry mouth and dry eyes, your doctor may recommend that you use an enzymatic mouthwash or an artificial saliva preparation, so that moisture is restored to your oral cavity.

Your doctor may also prescribe lubricating eye drops to help prevent excessive dryness.

The Bottom Line on Chronic Sinus Infections

While it is common to get an occasional sinus infection, frequent or chronic sinus infections could be related to a preexisting medical condition.

If you get repeated episodes of sinusitis, see your doctor, who will evaluate your symptoms and medical history and recommend diagnostic testing to determine the cause. Whether you need a balloon sinuplasty, or more information about acute and chronic sinusitis, book an appointment now to start your path to sinus relief.

Chronic Sinusitis & Diabetes

Hey all,
I have been having some rather pressing issues going on with my body and I am really unsure as to what is going on. I have seen 4 doctors and so far no one really has an answer for me as to what is happening with my body.
Long story somewhat short: I had sinus surgery 2 years ago for deviated septum and found out the day of surgery that I was diabetic. After surgery, I was started on Metformin (was already taking Lisinopril for HBP). After 7 months after my surgery and the beginning of my metformin use, I started to get really shaky and uneasy and had what was called a syncope episode (by the ER) while driving on the highway. I did not crash, however, came close. Since then I have had some pretty serious anxiety towards driving but that is besides the point… fast forward now to January of this year… I started getting crazy dizzy spells and pressure in my ears. I have been off and on to doctors… I have been to two ENTs who prescribed me antibiotics, my general doc which ordered a cat scan that came back negative for tumors, etc.
I am now on another round of antibiotics but things aren’t getting better. I am wondering if I have something else wrong with me or if there is some crazy drug interaction I am having… I have checked drugs.com and a few other interaction checker sites and it says nothing about my meds interfering but I am starting to get to my wits end…
I am on Metformin, Lisinopril, and Lovastatin. I have changed my diet somewhat but have had a few bad eating days here and there. My sinusitis is chronically affecting me and my anxiety levels are through the roof. This all happened within the 6 month diagnosis of my diabetes, my surgery, and my start of all my meds. My question to people is: is any of this fairly common for diabetes? Am I just experiencing the crazy side effects of my meds? The uneasy/dizzy feeling I have, the ear pressure and sinus problems and whatnot… just so uncertain and my doctors can’t seem to find out why I am feeling the way I am. It’s been close to 9 months now that I have lived like this and it isn’t getting better. Any replies are welcome and thank you all for your time. You guys really do make me feel better coming here and have a great evening.
-Rob

Hyperglycaemia (high blood sugar)

Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It’s a common problem for people with diabetes.

It can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes.

It can occasionally affect people who don’t have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack, or have a severe infection.

Hyperglycaemia shouldn’t be confused with hypoglycaemia, which is when a person’s blood sugar level drops too low.

This information focuses on hyperglycaemia in people with diabetes.

Is hyperglycaemia serious?

The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you’re likely to experience hyperglycaemia at some point.

It’s important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated.

Occasional mild episodes aren’t usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods.

Very high blood sugar levels can cause life-threatening complications, such as:

  • diabetic ketoacidosis (DKA) – a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma; this tends to affect people with type 1 diabetes
  • hyperosmolar hyperglycaemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar; this tends to affect people with type 2 diabetes

Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels.

If you experience hyperglycaemia regularly, speak to your doctor or diabetes care team. You may need to change your treatment or lifestyle to keep your blood sugar levels within a healthy range.

Symptoms of hyperglycaemia

Symptoms of hyperglycaemia in people with diabetes tend to develop slowly over a few days or weeks. In some cases, there may be no symptoms until the blood sugar level is very high.

Symptoms of hyperglycaemia include:

  • increased thirst and a dry mouth
  • needing to pee frequently
  • tiredness
  • blurred vision
  • unintentional weight loss
  • recurrent infections, such as thrush, bladder infections (cystitis) and skin infections

Symptoms of hyperglycaemia can also be due to undiagnosed diabetes, so see your GP if this applies to you. You can have a test to check for the condition.

What should my blood sugar level be?

When you’re first diagnosed with diabetes, your diabetes care team will usually tell you what your blood sugar level is and what you should aim to get it down to.

You may be advised to use a testing device to monitor your blood sugar level regularly at home, or you may have an appointment with a nurse or doctor every few months to see what your level is.

Target blood sugar levels differ for everyone, but generally speaking:

  • if you monitor yourself at home – a normal target is 4-7mmol/l before eating and under 8.5-9mmol/l two hours after a meal
  • if you’re tested every few months – a normal target is below 48mmol/mol (or 6.5% on the older measurement scale)

What causes high blood sugar?

A variety of things can trigger an increase in blood sugar level in people with diabetes, including:

  • stress
  • an illness, such as a cold
  • eating too much, such as snacking between meals
  • a lack of exercise
  • dehydration
  • missing a dose of your diabetes medication, or taking an incorrect dose
  • over-treating an episode of hypoglycaemia (low blood sugar)
  • taking certain medicines, such as steroid medication

Occasional episodes of hyperglycaemia can also occur in children and young adults during growth spurts.

Treating hyperglycaemia

If you’ve been diagnosed with diabetes and you have symptoms of hyperglycaemia, follow the advice your care team has given you to reduce your blood sugar level.

If you’re not sure what to do, contact your GP or care team.

You may be advised to:

  • change your diet – for example, you may be advised to avoid foods that cause your blood sugar levels to rise, such as cakes or sugary drinks
  • drink plenty of sugar-free fluids – this can help if you’re dehydrated
  • exercise more often – gentle, regular exercise such as walking can often lower your blood sugar level, particularly if it helps you lose weight
  • if you use insulin, adjust your dose – your care team can give you specific advice about how to do this

You may also be advised to monitor your blood sugar level more closely, or test your blood or urine for substances called ketones (associated with diabetic ketoacidosis).

Until your blood sugar level is back under control, watch out for additional symptoms that could be a sign of a more serious condition (see below).

When to get urgent medical attention

Contact your diabetes care team immediately if you have a high blood sugar level and experience the following symptoms:

  • feeling or being sick
  • abdominal (tummy) pain
  • rapid, deep breathing
  • signs of dehydration, such as a headache, dry skin and a weak, rapid heartbeat
  • difficulty staying awake

These symptoms could be a sign of diabetic ketoacidosis or a hyperosmolar hyperglycaemic state (see above) and you may need to be looked after in hospital.

How to prevent hyperglycaemia

There are simple ways to reduce your risk of severe or prolonged hyperglycaemia:

  • Be careful what you eat – be particularly aware of how snacking and eating sugary foods or carbohydrates can affect your blood sugar level.
  • Stick to your treatment plan – remember to take your insulin or other diabetes medications as recommended by your care team.
  • Be as active as possible – getting regular exercise can help stop your blood sugar level rising, but you should check with your doctor first if you’re taking diabetes medication, as some medicines can lead to hypoglycaemia if you exercise too much
  • Take extra care when you’re ill – your care team can provide you with some “sick day rules” that outline what you can do to keep your blood sugar level under control during an illness.
  • Monitor your blood sugar level – your care team may suggest using a device to check your level at home, so you can spot an increase early and take steps to stop it.

What should a person with diabetes do if they get sick with flu or cold?

There are everyday actions people can take to stay healthy. Try to avoid close contact with sick people.

Flu spreads mainly person-to-person through the coughing or sneezing of infected people. If you get sick, the CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

  • Be sure to continue taking your diabetes pills or insulin. Don’t stop taking them even if you can’t eat. Your health care provider may even advise you to take more insulin during sickness.
  • Test your blood glucose every four hours, and keep track of the results.
  • Drink extra (calorie-free) liquids, and try to eat as you normally would. If you can’t, try to have soft foods and liquids containing the equivalent amount of carbohydrates that you usually consume.
  • Weigh yourself every day. Losing weight without trying is a sign of high blood glucose.
  • Check your temperature every morning and evening. A fever may be a sign of infection.

Call your health care provider or go to an emergency room if any of the following happen to you:

  • You feel too sick to eat normally and are unable to keep down food for more than 6 hours.
  • You’re having severe diarrhea.
  • You lose 5 pounds or more.
  • Your temperature is over 101 degrees F.
  • Your blood glucose is lower than 60 mg/dL or remains over 300 mg/dL.
  • You have moderate or large amounts of ketones in your urine.
  • You’re having trouble breathing.
  • You feel sleepy or can’t think clearly.

For more information, see:

  • Diabetes and the Flu (Flu.gov)
  • Flu and People with Diabetes (CDC)
  • Taking Care of Your Diabetes at Special Times: When You Are Sick from the National Diabetes Information Clearinghouse fact sheet, Your Guide to Diabetes: Type 1 and Type 2.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *