On one of our DiabetesCare.net forums, I had a question on cellulitis and diabetes. After answering the question, I thought it would be a good blog topic to share with you. My goal is to teach you about cellulitis to learn more about taking good care of yourself.

cellulitis is a condition that needs to be taken very seriously especially with diabetesIf you have diabetes, be extra careful of your skin. Infections are more common and when blood glucose is high, it will potentially feed the infection. (1) Cellulitis is an infection found in skin and tissues that are found directly under the skin. It can be caused by many types of bacteria including streptoccus, staphylococcus and methicillin-resistant staphylococcus aureus (MRSA). People that have diabetesare at a higher risk of developing cellulitis and in some cases, can spread rapidly. (2) 

Some people confuse cellulite with cellulitis. Cellulite is composed of fat that pushes up against connective tissue making the skin pucker. It is not harmful. (3) Cellulitis is different; it is an infection that can be very harmful.

Any infection causes an increase in blood glucose. This happens in all people (even in people that usually have their values under control). In people without diabetes, the extra glucose is released to help fight the infection. Their body will also release extra insulin to handle the extra glucose. When a person has diabetes, this extra rise in the glucose can cause problems. (4) Diabetes can also cause the skin to be susceptible to bacteria by slowing blood flow. (5) 

What are the signs and symptoms of cellulitis? 

The most identifiable signs of cellulitis are pain and tenderness, swelling, redness and warmth over an area of skin. The number of white blood cells increase to help fight the infection. The area becomes swollen. Fever and chills may also develop. The skin may develop blisters (but not always). (2,6) 

In adults, cellulitis develops most often in the legs and feet. In children it is frequently seen on the head and neck. It can develop anywhere on the body but frequently at the site of wounds, burns, insect or animal bites or a surgical incisions. (7) It can occur anywhere that the skin has been punctured or injured. This can include an injury that may form from fungal infections such as “athletes’ feet”. Cellulitis usually is only on one side of the body (example one leg).

How does cellulitis develop?

Bacteria usually enters the body through the break in the skin. This break can be of any size. In some cases of cellulitis, the break in the skin cannot be found. Sometimes in cases where athlete’s foot is present, the break may be from the fungus in the foot. The cellulitis may develop from the bacteria that enters the break in the skin at the foot level which may travel to the lower leg. The area has infection present and can spread very rapidly. (8) 

What can I do to prevent cellulitis?

Take care of your skin which would include taking precautions to prevent cuts and wounds. Steps to decrease the possibility of developing cellulitis include:
•    Ask professionals on your diabetes healthcare team to learn how to inspect your feet and other body parts for problem areas. Follow through with the recommendations. 
•    Go to a podiatrist or other qualified foot care professional for recommendations and help to acquire shoes and footwear that fit. Ask what you should wear at the beach or pool, in your house and everywhere. 
•     Ask your healthcare team for more advice on cellulitis prevention. 

What should I do if I suspect I have cellulitis?

•    Call your doctor or healthcare professional immediately. 
•    A doctor or qualified heath care professional needs to assess the area to determine the extent of the cellulitis and mediation to use to treat it. A biopsy may be needed. The doctor may order oral antibiotics medications that you would take by mouth. Many cases of cellulitis need intravenous antibiotics. A person may need to be admitted to the hospital for this. In the hospital, the doctor would have access to other experts for consultation. (9) 
•    Ask questions of your healthcare team. Ask for written information on your care and how to prevent cellulitis from happening again. 
•    Here is additional information on cellulitis in children