Friday, May 18, 2012

Cellulitis and Diabetes

Cellulitis is a common skin infection
The word "cellulitis" actually means "inflammation of the cells." Cellulitis is a noncontagious, spreading inflammation of the connective tissue of the skin, typically resulting from a bacterial infection. 

Normal skin has many types of bacteria living on it. When there is a break in the skin, these bacteria can cause a skin infection. Skin in the infected area will become red, hot, irritated, and painful. 

Unlike impetigo, which is a very superficial skin infection, cellulitis is an infection that also involves the skin's deeper layers: the dermis and subcutaneous tissue. The main bacteria responsible for cellulitis are Streptococcus and Staphylococcus ("staph"), the same bacteria that can cause impetigo.
Risk factors for cellulitis include:
  • Cracks or peeling skin between the toes
  • History of peripheral vascular disease
  • Injury or trauma with a break in the skin (skin wounds)
  • Insect bites and stings, animal bites, or human bites
  • Ulcers from certain diseases, including diabetes and vascular disease
  • Use of corticosteroid medications or medications that suppress the immune system
  • Wound from a recent surgery

Symptoms of cellulitis include:
  • Fever
  • Pain or tenderness in the affected area
  • Skin redness or inflammation that gets bigger as the infection spreads
  • Skin sore or rash that starts suddenly, and grows quickly in the first 24 hours
  • Tight, glossy, "stretched" appearance of the skin
  • Warm skin in the the area of redness
Cellulitis and Diabetes
People who have diabetes or conditions that compromise the function of the immune system (for example, HIV/AIDS or those receiving chemotherapy or drugs that suppress the immune system) are particularly prone to developing cellulitis.

Diabetics are more susceptible to cellulitis than the general population because of impairment of the immune system; they are especially prone to cellulitis in the feet, because the disease causes impairment of blood circulation in the legs, leading to diabetic foot/foot ulcers. Poor control of blood glucose levels allows bacteria to grow more rapidly in the affected tissue, and facilitates rapid progression if the infection enters the bloodstream. Neural degeneration in diabetes means these ulcers may not be painful and thus often become infected.
Conditions that reduce the circulation of blood in the veins or that reduce circulation of the lymphatic fluid (such as venous insufficiency, obesity, pregnancy, or surgeries) also increase the risk of developing cellulitis.

As of 2011, there were 25.8 million children and adults in the United States—8.3% of the population—have diabetes. About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage.  Because cellulitis is not a reportable disease, the exact prevalence is uncertain.  However, with diabetes rates increasing the chances of developing complications such as cellulitis have become more common than ever. 


Treatments of Cellulitis
The intent of cellulitis treatment is to decrease the severity of the infection, speed up recovery, relieve pain and other symptoms, heal the skin, and prevent the infection from coming back.

Antibiotics are usually used to treat cellulitis. If the infection is limited to a small area, has not spread to the bloodstream or lymph system, and you don't have any other medical problems, antibiotics you take by mouth (oral) are effective. If the infection is more widespread, or if you're having a slow recovery on oral antibiotics, antibiotics may be used intravenously (IV) or by injection.
Treatment sometimes requires a stay in the hospital. This is common if antibiotics must be given intravenously. But a hospital stay is also considered if you have signs of complications such as a high fever or if it will be hard for you to have follow-up care with a doctor.

For cellulitis of the leg or arm, treatment also includes elevating the limb to reduce swelling.

Preventing a recurrence of cellulitis

Cellulitis tends to recur in people who have certain medical conditions that can lead to skin breakdown, such as edema (fluid buildup), fungal or bacterial infections, diabetes, or peripheral arterial disease.

If you have edema, support stockings and good skin hygiene may reduce or eliminate recurrence of cellulitis.   I would also recommend closely following a diet meant to reduce inflammation and swelling.  I have mentioned this diet often because I believe it is great resource for all of us to reduce the chronic low-level inflammation encountered from stress and the SAD (Standard American Diet).  I recommend it to everyone suffering from severe inflammation and/or swelling due to injury or illness as well.  Link -->Anti-Inflammatory Diet.  The only real change I recommend to this diet is to lower the level of soy intake.  Rather than including it is a daily food source, I would use it as a condiment.  We ingest more soy than we realize from processed foods and adding another daily serving of it I think is too much.

If you are considered very high risk for recurring cellulitis or have frequent fungal infections, regular use of antifungal medicines and/or antibiotics may help reduce recurrent cellulitis. 

There are some nutritional antifungal treatments that you could add to your daily diet to help also.  The first is probiotics.  Use of antibiotics leads to overgrowth of the normal intestinal yeast, which may either initiate problems or compound existing symptoms. By replacing the normal intestinal flora, yeast overgrowth may be inhibited. Probiotics are these normal flora. These are bacteria used in making yogurt- they are the “live active cultures” you see in the ingredients. They are important for the manufacture of B vitamins. They also protect against radiation damage, cancer, eczema, acne, allergies, and digestion disorders.

The next is garlic.  Garlic in its natural form is a highly effective, broad-spectrum antifungal.  It can be eaten whole, cooked in recipes, ground up in a carrot juice, or taken as a supplement that offers it in its whole, albeit dried, form.

Finally, most herbs and many vitamins that display health benefits, like the antioxidants (Vit. E, A, C, Zinc, etc.), have antifungal properties.  Increasing your intake of vitamin C is a great natural treatment as it will boost your immune response as well. 

Here is a list of other common natural antifungal treatments.  Consult with your doctor before trying the others on this list as is always the possibility of problems with drug interactions.  Natural Antifungal Treatments


Sources
http://www.medicinenet.com/cellulitis/page3.htm

http://www.bjdvd.com/content/9/2/75.full.pdf

http://www.cellutitis.org/cellulitistreatment.html

http://www.diabetes.org/diabetes-basics/diabetes-statistics/

http://www.health.harvard.edu/fhg/updates/update0905c.shtml

http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet




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