Diabetes and UTI (Urinary Tract Infection): Symptoms and Treatments

Diabetics have irregular levels of sugar in their bloodstream, ultimately leading to a weak immune system. Urinary tract infections (UTIs), except for pyuria, are caused by bacteria. High blood sugar in your bloodstream promotes faster bacterial growth, and a weak immune system cannot fight it effectively. Hence, people with diabetes are more susceptible to getting this health condition, and that too of severe intensity due to their weak immune system.

According to Nationwide Children’s Hospital, people with diabetes are up to 10 times more likely to develop a UTI, with women at higher risk compared to men because of the smaller urethral tube.

Types of Urinary Tract Infections: Their Locations and Causes

A urinary tract infection (UTI) occurs when microbes invade and multiply anywhere along the urinary tract — including the urethra, bladder, ureters, or kidneys.

Connection Between Diabetes and UTI

The link between diabetes and UTI in females and males is well-established:

• High blood sugar creates a favorable environment for bacterial growth.
• Weakened immunity reduces the body’s ability to fight infections.
• Diabetes urinary complications such as nerve damage, slow bladder emptying — increase infection risk.
• Frequent urination diabetes patients allows bacteria to ascend the urinary tract.

Psoriasin Deficiency Due to Diabetes:

A 2022 article in Medical News Today noted that diabetes may reduce levels of psoriasin — a natural antimicrobial protein in the bladder lining. Low psoriasin makes it easier for bacteria to colonize, increasing the risk of recurrent UTI in diabetes.

Still using fingersticks?

You may be eligible to claim a continuous glucose monitor (CGM), such as Freestyle Libre 2 Plus sensors, from CGM Monitors, using your insurance. These sensors allow you to monitor your blood sugar 24/7, without even pricking your fingers, and make informed decisions to keep your sugar in control.

UTI Without Bacteria: Pyuria

Pyuria refers to white blood cells in urine without detectable bacteria. It’s often due to:

• Previous antibiotic use
• Kidney stones or inflammation
• Diabetes bladder infection with fastidious organisms
• Viral or fungal infections (Candida in particular in diabetics)

Diabetes and UTI in Females

According to Dr. Robin Barry of Medical News Today, women with diabetes face a higher risk of urinary tract infections (UTIs) and recurrence due to high blood sugar, weakened immunity, and urinary tract changes. In men with diabetes, the risk is lower, about a quarter, but often linked to additional conditions such as prostate enlargement. Maintaining good blood glucose control, practicing proper urinary hygiene, and promptly treating infections are key preventive strategies for both men and women.

When blood sugar control improves, the frequency of UTIs decreases and vice versa.

Many Women that are fighting against UTIs says, “Better blood sugar control = fewer UTIs.”

Research highlights that in pregnant women without diabetes, the prevalence of symptomatic UTI ranges from ~3% to 10.1%. In contrast, among pregnant women with diabetes, the prevalence can reach up to ~27.6%. It is due to elevated glucose and hormonal changes during pregnancy. If you want to know more about diabetes gestational diabetes, then read on.

Acute and Chronic Symptoms of Urinary Tract Infections

A study shared by PubMed suggests that upon testing UTIs in diabetic and non-diabetic patients, diabetics were found to have higher fever with painful urination, often with a burning sensation, while the other symptoms remained the same.

When uncertain of UTI, you may need to watch out for:

Early UTI Symptoms:

• Strong, frequent urge to urinate
• Burning sensation while peeing
• Cloudy or foul-smelling urine
• Abdomen pain or pelvic pressure
• Frequent urination (diabetes) worsening

Severe UTI Symptoms (Complications):

• Back or flank pain
• Fever and chills
• Nausea or vomiting
• Pain in the groin (area where abdomen meets upper thigh) or side
• Blood in urine (hematuria)

Dangerous UTI Complications in Diabetics

Some infections require urgent medical attention:

Prevention of UTI in Diabetics

Prevention of UTI in diabetics is key to reducing recurrence and complications:

1. Control blood sugar: Tight glucose control lowers bacterial growth. You can use a CGM device like Dexcom G7 or FreeStyle Libre 3 Plus.
2. Hydrate well: Dilutes urine and flushes bacteria.
3. Don’t hold urine: Empty bladder regularly.
4. Hygiene: Wipe front to back, especially for diabetic women and UTIs risk reduction.
5. Post-sex urination: Reduces bacterial entry.
6. Wear breathable underwear: Prevents moisture buildup.
7. Avoid unnecessary antibiotics: They disturb protective microbiota.

Diabetic Urinary Tract Infection Treatment

Treatment depends on infection type and severity. Never make a medical decision without consulting a doctor.

Common Medications:

Always complete the full course of antibiotics — stopping early can lead to recurrent infection or resistance.

Important: According to a study shared by PubMed, UTI patients who received vaginal ovules containing Lactobacillus spp. following antimicrobial treatment, were found with a recurrence rate of 21% only.

Lifestyle Choices During UTI

• Sexual activity: It’s best to pause sexual intercourse until the infection clears to avoid worsening irritation and spreading bacteria.
• Diet: Limit sugar and processed foods to prevent fueling bacterial growth.
• Probiotics: May help restore healthy urinary flora. While Lactobacillus strains are found to create an acidic environment, limiting bacterial crowding, yogurt may also be beneficial.

Confirm It’s a UTI — Not Something Worse

Don’t ignore persistent symptoms. Ensure your doctor rules out:

• Emphysematous cystitis
• Pyelonephritis
• Fungal infections (Candida)
• Kidney abscesses

Untreated, these conditions can lead to sepsis or permanent kidney damage.

Final Thoughts

Upon noticing even the slightest symptoms of UTI, see a Doctor. Start with a urologist. If infections are recurrent, severe, or involve the kidneys, you’ll likely be referred to a nephrologist.

Seek emergency care if you have a fever, back pain, vomiting, or blood in your urine. While this health condition is common, urinary tract infections in diabetics are often more severe and recurrent compared to non-diabetics.

Careful blood sugar control, early diagnosis, and prompt treatment are critical. Always take UTI symptoms in diabetes seriously, and remember, timely care can prevent life-threatening complications.

Frequently Asked Questions