Research and case studies have found a dangerous relationship between diabetes and antibiotics. In a statistical study conducted in spring of 1999 by JoAnn Deasy, PS-C, MPH, on the risk of infection among diabetics, Deasy found that the risk ratio in diabetics was 1.21 versus non-diabetics with 46% of diabetics needing at least one hospitalization or doctors visit for infection compared with 38% amongst non-diabetics. The increased rate of infection and susceptibility to complications results in the frequent prescription of antibiotics to diabetics. While antibiotic therapy has proven results, there are some that put diabetics at severe risk.
Diabetes and Antibiotics for Respiratory Infection
Diabetics are four times as likely to die from a respiratory infection than the general population. In his case study, Muhammad Mamdani of the Institute for Clinical Evaluative Sciences created a database of patients over 65 who visited hospitals after they had hypo- or hyperglycemia that had been given oral fluoroquinolone with a total of 1,258 cases. The study found that patients who had hypoglycemia (788) were more than four times likely to have used gatifloxacin in both diabetic and non-diabetics, with fewer than half admitted to hospital and 8.1% dying. Patients who had hyperglycemia (470) were more than 17 times as likely to have been treated with gatifloxacin, with half being admitted to hospital and 16.5% dying. The frequency of other antibiotics that were also found to cause dysglycemia within 30 days of prescription is ciprofloxacin (0.3%), levofloxacin (0.3%), mixofloxacin (0.2%), second-generation cephalosophins (0.2%), and macrolides (0.1%) although the statistics are probably conservative in terms of actual occurrence (http://www.cmaj.ca/content/174/8/1089). Both diabetics and non-diabetics are at risk of dysglycemia, those with diabetes should take special care and take alternatives to gatifloxacin when possible.
Diabetes: Antibiotics Used for the Treatment of Foot Infection
Linezolid is used in the treatment of diabetic foot infections, particularly resistant strains such as MRSA. In a study Linezolid was shown to cure 71.3% of infections in a test group of 350 individuals. In another study comparing Linezolid with Cipro, Linezolid healed foot ulcers far faster. While the results are encouraging, there is also evidence of complications for diabetes and antibiotics. In a study of the Department of Pharmacy, Cambridge Health Alliance, Bell’s palsy was reported in a 49-year-old man who had insulin dependent diabetes and a history of diabetes related foot problems. After a treatment for a staph infection, he was discharged and given Linezolid. On the 23rd day of treatment he developed symptoms of Bell’s palsy, which improved after three months of quitting Linezolid treatment. When he was given the medication a second time the symptoms returned.
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