know How Can You Get Fever With Diabetes
Presence of fever in a diabetic is a sign to be approached with caution . It could represent a benign subjective sense of feverishness or an underlying serious problem.
Infective foci should be carefully searched for , even in cases of obvious non infective hypothermia , as all infections could rapidly deteriorate due to the decreased immunity in a hyperglycemia individual. The protocol for evaluating fever is same as in a nondiabetic individual , with particular attention to search for common infections found in diabetic patients.
Deficiency in innate immunity is apparent in diabetes, more than the changes in adpative immunity. Neutophil chemotaxis, phagocytosis and impaired bactericidal activity are important predisposition to infection in diabetes . Humoral immunity is generally spared, therefore response to vaccines are intact.
Organism specific factors play in case of candida , klebsiella and Melidosis , which are much more common in diabetic individual.
Presence of hyperglycemia is needed for malignant otilis external , mucormycosis and gingivitis.
Also, absence of fever in a diabetic with obivous spesis cold be a bad prognostic sign, which could represent failure of immune system to mount resistance.
Fever With Diabetes
Fever can disturb the glycemic control ,due to factors like increased BMR, decreased food intake , drugs and mounting stress response.
SICK DAY RULES APPLY IN ALL FEVER CASES: Fever With Diabetes
- Never omit insulin
- Prevent dehydration and hypoglycaemia
- Frequent blood sugar monitoring
- Supplemental fast action insulin
- Treat the underlying trigger factor
- Frequent contact with the health care team
Even if oral intake is less , infection can induced insulin resistance, thereby necessitating increased or supplemental doses of insulin. In general , supplemental insulin dosages are based on the blood glucose level and the urinary ketone result, where short acting insulin is repeated at regular intervals. In patients with blood glucose levels below 250mgdl, no supplement is needed . Blood sugars between 250 to 400mg/dl may need 10% of total daily dose required as supplemental dose, given in dived doses . More than 400mg/dl blood sugar levels require 20% of the TDD.
Sugar free drinks are recommended in patients taking solids . Patient should be suggested to keep a sick day cupboard.
Experience suggests that families can successfully manage most of the intercurrent illness at home without recorse to a hospital.
Thus, fever in diabetic patients is an important symptoms that brings the patient to caregiver for advocating proper treatment.