It is very common for individuals with type 2 diabetes to suffer from frequent episodes of urinary tract infections (UTI). These are more complicated among those with uncontrolled diabetes, especially women. Recurrent UTIs along with poorly controlled sugars can result in increased risk of chronic kidney disease. This can complicate the life of a diabetic to a great extent .

Causes of urinary tract infections

Poor immunity – Uncontrolled blood sugar levels lowers both B and T cell function thereby compromising immunity. This makes them susceptible to all kinds of bacterial, viral and fungal infections in all body organs

Poor metabolic control– High levels of sugar/glucose in urine promotes growth of pathogenic bacteria. This results in infections

Incomplete bladder emptying – Most individuals with prolonged diabetes develop autonomic neuropathy / decreased senses. This lowered sensory response affects all organs including the urinary tract causing incomplete voiding of urine. Older women with long-standing diabetes usually have bladder dysfunction and are more prone to urinary tract infections.

Symptoms

  • Pain or burning during urination
  • Need to urinate more often than usual
  • Feeling of urgency during urination
  • Blood or pus in the urine
  • Cramps or pain in the lower abdomen
  • Chills or fever (fever may be the only symptom in infants and children)
  • Strong smelling urine
  • Pain during sexual intercourse
  • Nausea, vomiting

Diagnosis

  • Mid-stream urine sample analysis
  • Urine culture
  • USG of kidney in suspected cases of complications

How to prevent UTI’s

Keep hydrated: It is important to remain well hydrated so as to allow dilution of the urine. Lack of water causes the urine to get concentrated and the acidic urine can cause irritation and growth of unhealthy bacteria. Sometimes, we do not drink much water despite being thirsty to avoid using the washrooms outside the home but this can be very detrimental. Timely response to thirst helps remain hydrated and maintain fluid balance in the body.

Clean thoroughly: Cleaning the anal region properly with water or a damp cloth every time after urination can prevent bacteria from spreading elsewhere.

Avoid using unnecessary creams or cosmetics: Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.

Vitamin C rich fruits and juices: having plenty of vitamin C containing fruits or vegetables such as oranges, sweet limes, lemons, cabbage, etc can help to increase pH of the urine and also have an antioxidative effect to fight against free radicals

Antioxidant-containing foods: Other foods rich in antioxidants such as cranberries, green tea, cherries, tomatoes, pumpkin can prevent the proliferation of pathogenic bacteria

Urinary Tract infections can be very painful and cause lot of discomfort among elderly diabetic patients. Once a UTI develops it is most likely to recur within 6 months because the effect of antibiotic wears off or pathogens becomes resistant.  The best prevention strategy is to keep the blood sugar levels under control by regular monitoring alongwith following healthy diet and physical activity.

References:

https://www.ncbi.nlm.nih.gov/pubmed/26013793

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346284/

http://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/basics/prevention/con-20037892

http://umm.edu/health/medical/altmed/condition/urinary-tract-infection-in-women

Written by drpoojachhawcharia

Dr Pooja Chhawcharia is the Senior Nutritionist at eKincare with over 7 years of experience in Nutrition education, diet counseling and research. She is a Registered Dietician with the Indian Dietetic Association and Certified Diabetes Educator recognized by the International Diabetes federation . She is also interested in ancillary sciences such as Yoga and Naturopathy.

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