How can we prevent my mom, who has type 2 diabetes, from constantly getting yeast infections and cystitis?

A fellow caregiver asked...

Along with her diabetes my mother has recurrent bladder and vaginal infections. How can we put an end to them?

Expert Answer

Theresa Garnero is clinical nurse manager of Diabetes Services at California Pacific Medical Center in San Francisco.

First try helping her get her blood sugar levels in her target range. Uncontrolled diabetes is a notorious contributing factor to frequent vaginal and bladder infections. How is your mom's A1C (the lab test that shows a three-month blood sugar average)? An A1C of less than 7 percent means she has good control. But if her A1C results are above 7 percent then she needs help getting her diabetes under control. So find out her A1C results to determine if her repeated infections are due to sustained high levels of glucose, which is the perfect set-up for bacteria and yeast to thrive and resist treatment.

Surges in glucose levels increase the risk for infection. The vagina is prone to yeast infections, especially after a course of antibiotics. (If she needs antibiotics, suggest she eat yogurt to prevent this problem.) Other triggering factors are wearing tight, constricting clothing such as underwear or jeans and sex. It's important to address all of these issues and it may be delicate to bring them up with your mom. If you're not comfortable doing so, ask her diabetes educator or doctor to have a conversation with her about it.

Cystitis, an infection or inflammation of the bladder, is caused by bacteria entering this otherwise sterile environment. If your mom has had uncontrolled diabetes for many years, she may have decreased nerve function in the bladder. This means her bladder might not empty like it normally would, a condition known as neurogenic bladder, making her more susceptible to repeated urinary tract infections.

What can she do to remedy this situation aside from gaining control of her glucose levels as quickly as possible? Make sure she drinks plenty of water to stay hydrated (at least four tall glasses a day), avoids panty hose and constricting clothing, and maintains good personal hygiene (wiping from front to back after using the toilet, and taking daily baths or showers).