Diabetes and infections

PWD can develop infections with a prolonged course and complications more frequently. Chronic low-grade inflammation and reduced cytokine responses lead to metabolic derangement. Uncommon infections like mucormycosis and malignant otitis externa occur predominantly in PWD. Diabetes is one of the main risk factors for severe COVID-19 disease. Thirty percent of people with liver cirrhosis have type-2 diabetes. The urinary tract is the most affected site of infection in PWD. Globally, 5% of tuberculosis (TB) cases are attributable to diabetes. Foot infections are the leading cause of lower limb amputation in PWD. It is recommended to start an antibiotic that is initially empirical. Given the risk of antimicrobial resistance, it is mandatory to limit the use of antibiotics for infected wounds. It is important to note that no data support the use of systemic or topical antimicrobials to improve uninfected foot ulcers or preventing an infection.