Urinary Tract Problems in People with Diabetes

Having diabetes is associated with greater numbers of urinary tract infections, especially in patients who don’t have good control over their blood sugar [glucose] levels.

Urinary Tract Infections

Urinary tract infections, or UTIs, are caused by bacteria in the urinary tract. They can occur in the urethra (this infection is known as urethritis), the bladder (cystitis), or the kidneys (pyeloenphritis). In people without diabetes, the immune system normally takes care of these infections, which clear up on their own. However, UTIs and, in particular, acute pyelonphritis, is common in diabetes patients.

These UTIs may be due to diabetes-related nerve damage or an impaired immune system response. They may also be caused by glucose in the urine, which provides a good environment for bacteria to grow.

The symptoms of UTIs are not subtle and include:

  • Pain or discomfort while urinating
  • Persistent urge to urinate
  • Pain in the abdomen or back
  • Fever

UTIs are especially common in women, thanks to the close proximity of the vagina and anus to the urinary tract.

"Women with diabetes are more likely to suffer urinary and vaginal yeast infections than those without," says Amber Taylor, MD, Director of Diabetes at The Center for Endocrinology at Mercy Medical Center in Baltimore. "In fact, many women are diagnosed with diabetes by their gynecologist after frequent infections; the higher the blood sugars, the higher the risk of UTI and candidiasis [fungal infection]."

Urinary infections are less common in men, but can be severe when they do occur. However, a recent study of men in France showed an association between lower urinary tract syndrome (previously called prostatism) and metabolic syndrome, a very significant risk factor for type 2 diabetes. Metabolic syndrome describes a collection of symptoms, including abdominal obesity, high cholesterol, and high blood pressure.

Keep in mind that the correlation between metabolic syndrome and lower urinary tract syndrome in this study does not imply causation; Taylor says we need more data before we can definitely link the two.

Taylor notes that men with obesity are already at risk for diabetes and should be screened: "It is interesting to note that those with metabolic syndrome, especially a waist circumference greater than 40 inches, have a much higher likelihood of having prostatic symptoms and especially more severe symptoms than those without metabolic syndrome."

Preventing and Treating UTIs

You can take these steps to prevent urinary tract infections:

  • Drink plenty of water to flush your system.
  • Urinate when you have the urge and immediately after sex so bacteria can’t linger and grow.
  • Wear cotton underwear and loose-fitting clothes.
  • And, of course, effectively manage your blood sugar through diet, exercise, and medications (if needed).

A Treatment Warning

UTIs are treated with antibiotics, which inhibit or destroy bacteria and other microorganisms. But, as Taylor notes, "Patients with diabetes (especially women) are often predisposed to yeast infections, due to higher glucose in the urine. High blood sugar and a course of antibiotics are often a recipe for yeast infections, which can be unpleasant. Yeast infections are much less common in men, and less common in women with good blood sugar control (less sugar in the urine)." So if you have diabetes and are dealing with a UTI, speak to your doctor about your risk of yeast infection.

Amber Taylor, MD, reviewed this article.


Amber Taylor, MD, Director of Diabetes at The Center for Endocrinology at Mercy Medical Center in Baltimore. Email to author December 23, 2014.

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Hakeem, Lukman M., Diptendu N. Bhattacharyya, Cyril Lafong, Khalid S. Janjua, Jonathan T. Serhan and Ian W. Campbell. "Diversity and Complexity of Urinary Tract Infection in Diabetes Mellitus." British Journal of Diabetes and Vascular Disease 2009 9(3): 119-125.

"Urinary Tract Infections in Adults." National Institute of Diabetes and Digestive and Kidney Diseases. Last updated, May 24, 2012.

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