Chronic Cryptic Infections updated 11/2019


Terminology Breakdown


Chronic – having an illness persist for a long time or constantly recurring:


Cryptic – mysterious, difficult to understand; having or seeming to have a hidden meaning:


Infection – Invasion of the body or a body part by a pathogenic microbe (bacteria, virus or parasite) which multiplies and produces harmful effects on the body’s tissue.


Researchers have concluded that there is clinical evidence pointing to the higher prevalence of infectious diseases among individuals with Diabetes Mellitus (DM). Diabetes slows down the body’s ability to fight infection. Common sites of infection include your urinary tract, skin, kidneys, feet, gums, vagina, and respiratory system.


In fact, any infection is a cause of concern for those dealing with (DM). Even something as common as a cold can cause varying degrees of blood glucose (BG) instability with a trend towards rising glucose levels. When impacted by an infection, the body responds by releasing stress hormones such as cortisol and adrenaline that help fight an infection but also tend to cause a rise in blood glucose levels. At the same time, insulin resistance increases, causing a further rise in BG by disrupting the body’s ability to utilize glucose as an energy source. As BG levels rise, white blood cells that engulf microbes become sluggish and are unable to reach the infection site quick enough to prevent the microbe from establishing itself and overwhelming the body’s normal defensive mechanism.

This increase in blood sugar helps create an environment where microbes can thrive and multiply. If the infection goes unchecked in a type 1 diabetic, fats may serve as an alternate energy source, leading to ketone build-up that can be life-threatening resulting in DKA (diabetic ketoacidosis), diabetic coma or death.


In addition to being potentially more serious, infectious diseases in DM may result in metabolic complications such as hypoglycemia, hyperglycemia, and coma. More research is needed for clarification of the immune-pathogenic mechanisms linking DM and infections and to develop strategies to improve vaccination coverage for diabetic patients. The recommendation of compulsory immunization with pneumonia and flu vaccines is essential because of their impact on the reduction of respiratory infections, the number and length of hospitalizations and the number of deaths related to respiratory tract diseases.


For brittle diabetic patients with recurrent episodes of diabetic ketoacidosis (DKA) a possible chronic cryptic infection such as sinusitis, osteomyelitis, perinephric abscess or lung abscess should be considered and excluded by their physician. Physicians should recommend the establishment of a sick day plan including: staying hydrated; testing BG levels more frequently(every 2 to 4 hours); when over 250 testing one’s urine for ketones; continuing insulin usage despite not feeling like eating; substituting meals with easily digestible foods or liquids with similar carbohydrate value; and knowing when to seek medical treatment.