Diabetes and yeast infections

by Diana W. Guthrie, PhD, FAAN, CDE

Dr. Guthrie is a professor at the University of Kansas School of
Medicine-Wichita. She has a doctorate in Philosophy and Social Change and
works in behavioral psychology. In addition, Dr. Guthrie has her own diabetes
clinic.

Yeast infections, usually Candida, cause a terrible itching. Women who have a
change in the pH of the vaginal tissues are more susceptible to a yeast
infection. A yeast infection is accompanied by a yellow or white cheesy
discharge which is usually odorless (most other vaginal infections have an
odor to the discharge). This type of infection is most likely not sexually
transmitted. When the blood sugar is high, there is a greater chance for this
and other vaginal infections to occur. When a vaginal infection occurs, there
is a greater chance that the blood sugar will go higher than it presently
might be. Pain on intercourse is also likely to occur.
In a study of 203 women with diabetes, Candida albicans was isolated from
12.8% of all patients. This disease showed a significant association with the
woman who had vaginal and external vaginal itching. In the particular
population studied, of all the yeast infections identified, Candida glabrata
was found in 50% of the cases and Candida albicans next (36.1% of the cases).
Treatment in the United States has more recently become easier to obtain.
Antifungal medications are now available in over-the-counter preparations in
creams or suppositories. A person with diabetes must be wise in choosing to
use an over-the-counter preparation. First, blood glucose levels must be
normalized as much as possible. Second, if the recommended treatment time
(i.e., seven days) does not bring the desired results, a physician must be
consulted. If the infection is quite severe from the start, it is better to
consult a physician and obtain the proper cultures before starting the
treatment so that the specific organism(s) is(are) found. It is possible that
more than one organism is responsible for the vaginal infection. And third,
prevention is best. This means cleanliness (including good personal hygiene,
i.e., wiping from front to back), blood sugar control, completing the full
length of treatment (i.e, if treated, the suppositories or creams must be used
for the full seven-day course of treatment, not just until the symptomatic
itching and discharge go away), fruits and vegetables, exercise, and adequate
rest should be included as part of the daily life style, and drinking plenty
of fluids (preferably water) is a must. Other recommendations are the wearing
of cotton rather than nylon underwear. Tight clothing appears to aggravate the
itching and also prevents drying air to reach the infected area (eg, the
wearing of tight jeans or other tight clothing especially made of tightly
woven fabric). Douching is more harmful than helpful. Do not use douches
unless recommended by the health professional. Soap and water is better than
the use of a feminine hygiene spray. Safe sex must be practiced, especially if
there is more than one partner. And remember, if the blood sugars are out of
control, there will be a greater chance that the women will develop a yeast
infection or other types of vaginal infection.
There is a greater chance that a vaginal infection will occur if the person is
pregnant, taking oral contraceptive drugs, or menopausal. All these three
occurrences lead to the possibility of a change in the pH of the vaginal
tissues, so dietary intake is very important, even though a specific approach
to dietary intake is questioned by some. Again, prevention is the best
approach. n
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