Diabetes And Bladder Infections

Have you been visiting the bathroom more frequently than usual but feel like you need to go again? When urinating, do you feel stinging abdominal pain?

These and other symptoms suggest you might have a bladder infection, the most common among urinary tract infections (UTIs).

What are bladder infections?

A bladder infection is a urinary infection where the bladder gets infected. The infection leads to swelling and irritation, a condition known as cystitis.  

How can diabetes cause bladder infections?

Diabetes and bladder infections are closely related. Both men and women with diabetes mellitus are more prone to UTIs than people without diabetes. This is due to frequent urination and urinary incontinence. 

A clinical study by the National Institutes of Health (NIH) reveals that diabetes has a 30-70%¹ heightened risk of overall incontinence and a 50% increased risk of urge incontinence in women. 

Researchers think this is due to diabetes affecting the nerves in the bladder, also known as diabetic autonomic neuropathy. It can lead to urinary retention and trouble emptying your bladder, resulting in stagnant urine, a breeding ground for bacteria.

Increased blood glucose in patients with diabetes mellitus can increase the likelihood of getting a bladder infection. A high blood sugar level provides ideal conditions for bacterial growth. In uncontrolled diabetes, where the blood sugar remains elevated for long periods, it can result in progressive kidney failure or diabetic nephropathy. 

People with diabetes may also experience impaired innate, cellular, and humoral immunity. This makes the body more susceptible to bladder infections and other UTIs.

Other causes of bladder infection

Bacteria are the leading cause of bladder infections. If your body fails to flush these pathogens through urination, they may enter the bladder through your urethra.

Once in your bladder, they can attach to the walls and multiply quickly. If you don't get treatment, the body eventually becomes overwhelming, causing a bladder infection.

Escherichia coli (E. coli) bacterium is the main culprit. Your large intestines have this bacteria naturally. So if bacteria from your stool enters the urinary tract, an infection may occur. 

What's the difference between UTIs and bladder infections?

A bladder infection is a type of UTI. As the name suggests, UTI is a common urinary system infection.

The urinary system consists of different organs:

• Kidneys: Bean-shaped organs that filter blood to remove waste, producing urine

• Ureters: Tubes that carry urine from the kidneys to the bladder

• Bladder: A sac that stores urine to be released

• Urethra: A tube that passes urine out of the body

The kidneys and ureters form the upper urinary tract, while the lower urinary tract consists of the bladder and urethra.

The lower tract is more susceptible to bacterial infections. You may develop an ascending infection into the upper tract if you don't receive treatment.

The bacteria can affect the whole system or an organ. UTIs have different names depending on the area they're affecting:

• Cystitis: A bladder infection

• Urethritis: An infection of the urethra

• Pyelonephritis: A kidney infection

Common symptoms of bladder infections

Urinary symptoms include:

• Intense or frequent urge to empty your bladder

• A burning sensation or pain during urination

• Urine with a strong odor

• Urinating small amounts frequently

• Cola-colored, red, or bright-pink urine—a sign of blood

• Cloudy urine

• Pain in the lower back, pelvis, or pubic area

Risk factors

While bladder infection can affect anyone, women are more prone to the condition than men.

For men

1. Age

The risk for enlarged prostates (Benign Prostatic Hyperplasia or BPH) increases with age. If untreated, BPH can block the normal flow of urine, predisposing you to UTIs and infection in the prostate itself. 

2. Uncircumcised

Uncircumcised penises have a greater risk than circumcised ones. The bacteria can lodge under your prepuce (foreskin) and travel up your urethra.

3. Anal sex

The anus and rectum have a high concentration of bacteria. Anal sex can introduce pathogens to the urinary tract system.

For women

Women are at a higher risk of developing bladder infections than men, mainly due to anatomical differences. At least 40%-60%² of women develop at least one UTI during their lifetime, primarily a bladder infection. 1 in 4 women will experience a repeat infection.

1. Female anatomy

Female anatomy is a significant risk factor.

A woman's urethra is shorter than a man's, shortening the distance the pathogens must travel to enter the bladder.

Additionally, a woman's urethral opening is closer to the rectum, where bacteria are present.

2. Intense and frequent sexual intercourse

Intense thrusts during sex can easily push pathogens up the urethra and into the bladder. Being sexually active and changing sexual partners increases the likelihood of developing the infection.

Oral sex can also introduce bacteria into the urethra and bladder.

3. Menopause

Menopause is another factor that increases women's risk for bladder infection. The reason is reduced estrogen production and associated biological changes.

Estrogen allows lactobacilli bacteria to grow and thrive naturally in the vagina. These "good" bacteria produce a pH-lowering acid that controls the "bad' bacteria in the vagina.

So decreased estrogen levels promote a fertile breeding ground for the "bad" bacteria, increasing your risk of bladder infections and other UTIs.

Other physical post-menopause changes that heighten your risk of these infections include:

• Drying, irritated and thinning vaginal tissue

• Urine leakage (incontinence)

• Weakening and drooping pelvic organs plus floor (pelvic organ prolapse)

• Trouble emptying the bladder

4. Certain birth control types

Some birth control products may destroy the "good" bacteria. The result is an imbalance in the pH level, leading to a fertile ground for bacteria that cause infection. The "bad" bacteria eventually grow and thrive, increasing infection risk.

Birth control products like diaphragms can put pressure on the urethra. When this happens, it becomes harder to empty your bladder.

5. Pregnancy

The baby can exert pressure on your bladder, preventing complete emptying.

Other factors

Other lifestyle factors and medical conditions may increase the chances of developing a bladder infection:

• Neuropathy around the bladder

• Spinal cord injury

• Abnormality of the urinary system, such as vesicoureteral reflux (VUR)

• Recent use of a urinary catheter

• Previous UTIs

• Kidney stones that obstruct normal urinal flow

• A weakened immune system 

• Obesity

• Diabetic complications such as damage to nerves, high blood sugar, and immune dysfunction

Treatment for bladder infections

1. Antibiotics and other medicines

If your healthcare provider discovers that bacteria are causing your bladder infection, they'll likely prescribe antibiotics. The choice of antibiotics depends on the type of bacteria and any antibiotic allergies you have.

The treatment length depends on whether:

• The infection is severe

• The infection or symptoms fade

• You have repeated infections

• Your urinary tract has predisposing problems such as a kidney stone or prostatitis

For men, the length of treatment may be longer, especially if the bacteria enter the prostate gland and hide deeper inside the tissue. The prostate wraps around the urethra below the bladder.

Adhere to your doctor's instructions and complete the entire treatment even if you feel better. If you have diabetes and a bladder infection, your doctor may recommend diabetes medication.

It's worth noting that the diagnosis may be uncertain, or antibiotics may not work. Depending on test results and symptoms, your doctor will dig deeper to unearth the root cause and determine the best treatment for your symptoms.

Vaginal estrogen, probiotics, and "watchful waiting" may be excellent alternatives to antibiotics.

2. Over-the-counter pain medications

While antibiotics address the infection's cause, they don't deal with the pain or irritation in the pelvis or back area. Your doctor may prescribe painkillers to ease the discomfort.

3. Drink a lot of water

Drinking plenty of water and frequently urinating helps your body flush the pathogens out. The extra fluids can also dilute your urine, making urinating less painful as you heal.

Unlike artificial sweeteners, caffeine, and other beverages, water has no bladder irritants. Increasing your water intake can keep bladder reinfections at bay.

If you have other health issues that prevent you from drinking lots of liquids (e.g., kidney failure), seek personalized care and advice from your healthcare provider. 

4. Drink cranberry juice

A cup or two of cranberries every day can do wonders. The juice may help people with bladder infections feel better faster, thanks to its antibacterial properties. 

Health professionals and researchers suggest cranberry juice can prevent bladder infections and other UTIs. However, due to the sugar content, it may be better to take cranberry tablets instead.

5. Use a warm pack or a heating pad

A heating pad on your abdomen or back can ease infection pain.

How to avoid bladder infections

Certain lifestyle changes can maintain excellent bladder health and keep infections at bay:

• Drink 6-8 glasses of water daily.

• Drink a cup of cranberry juice daily or take cranberry tablets as instructed by your doctor.

• Visit the washroom immediately when you feel the urge to urinate.

• Don't rush; try to empty your bladder completely.

• Women should wipe from front to back.

• Avoid powders, douches, scented soaps, and hygiene sprays.

• Avoid baths; take showers instead.

• Wear loose-fitting clothes and cotton underwear for maximum aeration and drying of the area around the urethra.

• Avoid certain birth control methods, such as spermicide and diaphragms.

• Use non-spermicidal condoms or non-spermicidal lubricant.

• Urinate and clean the genital area before and after sexual intercourse.

• Cut down or avoid drinking alcohol and other beverages with urinary bladder irritants.

Your doctor may recommend preventative antibiotic treatment if you have recurrent bladder infections. They may suggest a daily dose, a single dose after sexual activity, or treatment when symptoms happen. They will also investigate why it keeps recurring.

When to consult a doctor

Are you experiencing symptoms consistent with a bladder infection, such as discomfort or pain when urinating? Contact a healthcare professional, especially if your symptoms have persisted for over two days.

Earlier treatment prevents the infection from moving up the urinary tract. This protects your kidneys and other body parts from harm.

Your doctor will examine you and take urine samples for lab analysis. Once your doctor receives your results, they'll prescribe the appropriate treatment.

Advanced symptoms like nausea, fever, confusion or back pain suggest a severe kidney infection. You may require high-dose antibiotics and IV treatment. Seek immediate medical care.

The lowdown

Bacteria are the most common cause of bladder infection and other UTIs. Diabetes and other risk factors may increase the likelihood of these infections. High blood sugar presents the ideal breeding ground for a bacterial infection, so controlling your blood glucose is vital. 

When you experience symptoms, seek treatment as early as possible before the infection spreads deeper into other body organs. Proactive and hygienic lifestyle changes may prevent infections.