Diabetes is a chronic condition that affects the body’s ability to use sugar — or glucose — from food for energy. It can lead to various health complications, including having a higher risk of developing urinary tract infections (UTIs).

People with diabetes do not make enough of the hormone insulin or cannot use it properly, leading to increased blood sugar levels. Without ongoing careful management, diabetes can lead to various health complications, such as heart disease and stroke.

In addition, UTIs are relatively common in people with diabetes. A UTI is an infection of the urinary system, which includes the kidneys, bladder, and urethra. It occurs when bacteria enter the urinary system.

This article explores the link between diabetes and UTIs, the symptoms of a UTI, and how to prevent them.

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There are a few reasons diabetes may increase the risk of a UTI.

One explanation could be that high blood sugar levels can affect blood flow and damage the nerves in the bladder. This damage can make it difficult for a person to know when they need to urinate. As a result, urine may be left in the bladder for too long, giving bacteria time to grow.

Another reason could be that diabetes can weaken the immune system, making it more difficult for the body to respond to infection. High blood sugar impairs the body’s defense mechanisms, typically protecting against UTIs. These actions can also reduce the levels of psoriasin, a natural antibiotic in the body.

Psoriasin typically stops bacteria from binding to the cells lining the bladder and multiplying.

Other risk factors for developing UTIs can include:

The signs and symptoms of a UTI can be different for everyone.

However, typical signs of a lower urinary tract or bladder infection include the following:

If a UTI spreads to the upper urinary tract and kidneys, it may cause:

In infants, fever is the most common sign of a UTI.

All pregnant people have an increased risk of developing UTIs, likely due to changes in the urinary tract. Typically, these changes stem from the weight of the fetus pressing onto the structures in the urinary tract and the relaxing effect of progesterone on the urinary tract muscles.

Pregnant people with either gestational diabetes or preexisting diabetes have an even higher risk of developing UTIs. In pregnant people without diabetes, the prevalence of symptomatic UTIs is 3–10.1%. However, in pregnant people with diabetes, it can be as high as 27.6%.

UTIs in pregnant people with diabetes are the most commonly observed infection. These infections are also more frequent and more likely to progress to kidney infections and abscesses.

Older individuals with diabetes also have an increased risk of developing UTIs.

The primary factors that may predispose them to UTIs may include the following:

  • having had a longer duration of diabetes
  • high levels of glycated hemoglobin (HbA1c, or A1C), a long-term marker of high blood sugar
  • sugar in the urine
  • white blood cells in the urine
  • increased ability of bacteria to bind to the urinary tract lining
  • dysfunctional bladders that contract poorly and do not empty fully
  • poor circulation and immune system function

Other conditions — such as dementia — are more common in this population, which can make it more challenging to manage their diabetes and prevent UTIs.

Older people with diabetes have a fivefold higher mortality risk due to UTIs than those without diabetes.

Generally, UTI treatment is similar for everyone, regardless of diabetes. A doctor will likely prescribe antibiotics to clear the infection.

Some examples of antibiotics that doctors prescribe include:

  • nitrofurantoin (Macrobid)
  • fosfomycin trometamol (Monuril)
  • trimethoprim-sulfamethoxazole (Bactrim)
  • quinolones (Trovan) and β-lactams (Tazobactam)

However, the choice of antibiotics is an important consideration for doctors, as there are possible drug interactions between certain antimicrobials and diabetes medications.

UTI treatment can also vary depending on the following:

  • gender
  • the person’s age
  • type of bacteria causing the infection
  • any other underlying conditions
  • whether there is lower or upper urinary tract involvement

Healthy lifestyle factors can help with diabetes and other health issues affecting the urinary tract. These include:

If an individual with diabetes has any signs or symptoms of a UTI, they must contact a healthcare professional immediately.

A UTI can cause serious complications if left untreated, which people with diabetes are at higher risk of.

Diabetes is a condition that leads to high blood sugar. It also increases the risk of developing a UTI. Pregnant people and older individuals with diabetes are especially at risk for UTIs.

Treatment generally involves antibiotics. The choice of antibiotic is important in people with diabetes as there are possible drug interactions with diabetes medications.

Healthy lifestyle factors can help prevent UTIs in people with diabetes. These include drinking plenty of water, maintaining a balanced diet, and exercising.

If an individual with diabetes has any signs or symptoms of a UTI, they must consult a healthcare professional immediately.