Question

A 55-year old female was admitted in the ER with a severe urinary tract infections of E.coli. Her history revealed she was diabetic and it had been uncontrolled for several years. Her glucose was 450mg/dL with ketoacidosis.

Why are urinary tract infections common in diabetics

What causes ketoacidosis? (please do not answer with "glucose", be specific....what causes it? what are ketones? etc.)

Why is it difficult for diabetics to heal from an infection

What other complications could this patient develop if he does not control his diabetes?

Answer 1

The diabetic patients are not much resistant to the pathogens due to underlying causes like low immunity, neuropathy, incomplete bladder emptying .The glucose present in the urine makes it a ideal place for the pathogens (bacteria)to grow and cause UTI

Diabetes refers to increase in blood glucose level.Insulin is needed to break this and release energy. The excess content are stored in the liver,muscles and in fat cells.When there is no enough insulin the glucose in the bloodstream cannot enter the cell and produce energy.Meanwhile body fats (as a compensatory mechanism) are broken down to produce energy in a faster pace.The breakdown products is ketones and the accumulation of it in the blood leads to ketoacidosis

The diabetic wound takes time to heal because of the presence of the glucose (which favours bacterial growth).The neuropathy affecting the wound site decrease the sensation and are highly pronefor painless injury.Also the lack of blood circulation needed for fighting the infection is very slow or absent ,asking the wound to heal slowly

The patient may develop microvascular disease if he doesn't control his diabetes

• Retinopathy :affecting the vision, permanent loss of vision
• Neuropathy :damage of nerves,which can lead to delayed wound healing ,loss of sensation making way for injury and permanent loss of function
• Nephropathy :kidney are damaged overtime

Answer 2

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