[Infection and diabetes]

Abstract

The susceptibility of diabetic patients to infection is well known, but there is a difference between susceptibility to bacterial and viral infections. Susceptibility to bacterial infections is obvious: septicaemias are more frequent in diabetics than in the non-diabetic population. Its mechanism is the influence of glycaemia on polymorphonuclear cell functions. Some particular clinical entities, such as urinary tract infection, "diabetic foot" or infectious cellulitis, are studied; their bacteriological characteristics may require changes in the first-line antibiotic therapy. It has been demonstrated that hyperglycaemia does not alter the pharmacokinetics of antibiotics. In all cases the role played by normoglycaemia must not be overlooked in the fight against bacteria. The viral infection problem is very different since, apart from autoimmune phenomena, the cellular and humoral responses are not modified in diabetic patients. A few, special mycological infections are also described.