Question:
I often get urinary tract infections because my sugars are constantly out
of control through no fault of my own. I believe they call it "brittle"
diabetes. Anyway, the doctors are reluctant to give me Bactrim all the
time because I do get these infections quite easily. They usually want me
tested first to make sure that's what my problem is also. The question I
pose to you is: is there anything I can do to either prevent these from
occurring or to fix the problem when it arises?
Answer:
You didn't mention how old you are or how long you have had diabetes.
It is unusual for uncomplicated high blood sugars to increase the
susceptibility to urine infections. On the other hand, a urine
infection can raise the blood sugars and insulin requirements and
contribute to difficulty controlling the blood sugar. Sugar in the
urine does predispose people to yeast infections, but these are not
treated with Bactrim (an antibiotic). It is important that you have a
urine culture when you have symptoms to document that you are in fact
having a true bacterial infection of the urine and to see which
antibiotic would work the best.
People with longstanding diabetes may have problems with the nerves that
control bladder function and may not completely empty their bladder
each time they urinate. If the bladder does not empty properly, there
is an increased chance of developing urine infections.
Of course, people with diabetes can also have problems unrelated to
their diabetes that could make them more prone to repeated urine
infection. You may need to have an ultrasound or other X-ray of your
kidneys to look for other problems that could predispose you to urine
infections or to look for problems that can be caused by repeated urine
infections.
It is important that you work closely with your physician to learn to
regulate your diabetes and adjust your insulin as necessary if you get
any kind of infection. You can discuss with your physician whether it
might help to see a urologist to try and found out if there is a
problem making you more prone to urine infections that can be treated
and to make sure you aren't developing other problems from repeated
infections.
TGL
Original posting 31 Oct 96