Health;Diabetes and genito urinary problems

Diabetes is a metabolic disorder where the normal metabolism of sugar is disturbed. As the body is not able to handle the load of sugar in the blood, levels of blood sugar go up. This makes the affected individuals more prone to infections because a high blood sugar forms favourable medium for bacteria and other germs to grow. All systems of the body are affected by uncontrolled diabetes mellitus, including the reproductive and urinary system. Involvement of the genitourinary system causes many problems to the sufferer. High levels of blood sugar are responsible for causing frequency of urination. In addition damage to the autonomic nervous system (system influencing the involuntary functions of the body) and peripheral nervous system by diabetes mellitus leads to multitude of urinary problems. An individual can develop frequency of urination, i.e. passing urine many times in small quantities. Retention of urine can also occur due to diabetes. Some persons can also have urinary incontinence, a situation where one loses voluntary control over passing urine. In this, whenever the urinary bladder is full, urine passes out involuntarily. This is a very embarrassing situation for any grown up person. Patients with diabetes are very susceptible to develop urinary tract infections because high levels of sugar in the blood provide a very rich medium for bacteria and other germs to grow. Women are more prone to this problem as short length of urethra (tube connecting bladder to outside for voiding urine), facilitates more easy entry of germs. Infection of the urinary tract also leads to increased frequency of urination. In addition due to bladder infection, one can have urgency of urination, i.e., once the urinary bladder is full, there is an intense urgent desire to pass urine immediately. Diabetic women are known to give birth to large size babies. Thus during delivery, they can have injuries to the perineum and urinary bladder, particularly the sphincter controlling the mouth of the bladder. This also manifests as retention of urine or incontinence. Repeated and persistent urinary tract infections can lead to chronic infection of the kidneys which can result in chronic kidney failure. In men diabetic autonomic neuropathy can lead to sexual impotence which is very disturbing for the affected person. Both men and women are susceptible to develop fungal infections of the genital parts and anus due to diabetes. Women have more chances of developing this problem. Fungal infections manifest as itching over the genital parts which is intermittent and troublesome. Secondary bacterial infection can set in due to scratching resulting in single or multiple boils. These infections subside temporarily with treatment to resurface again after some time under favourable conditions. Therefore to obtain a complete cure it is imperative that the individual takes treatment without interruption for 6 to 12 weeks and keeps sugar well controlled. All these problems can be avoided if a person if diabetic keeps his sugar well controlled. Strict adherence to a diabetic diet, regular physical exercise and medication helps in keeping diabetes well controlled. Avoidance of alcohol and smoking is also helpful in this regard. Good control of diabetes can delay or retard diabetic neuropathy and associated sexual impotence. But once erectile dysfunction develops, there is unfortunately no cure for it Drinking water in good quantity throughout the day flushes the urinary system very well and helps in preventing settlement of germs there. Thus it prevents development of urinary tract infections. Good perineal hygiene helps in preventing infection of the genital parts. One should always try to wash genital parts after intercourse to wash out the germs settled there. Women should be careful about personal hygiene during their menstrual cycles. These small measures keep away infections and prevent the resultant embarrassing problems. Dr. Rachna Pande Specialist internal medicine-Ruhengeri Hospital E-mail-rachna212002@yahoo.co.uk