From the Guidelines
Yes, diabetes can cause thrush, as elevated blood sugar levels create an environment where the Candida fungus can thrive, and diabetes can weaken the immune system, making it harder for the body to fight off fungal infections. According to the clinical practice guideline for the management of candidiasis: 2016 update by the infectious diseases society of America 1, oropharyngeal and esophageal candidiasis occur in association with HIV infection, diabetes, leukemia, and other malignancies. The study highlights that diabetes is a risk factor for developing thrush, and people with diabetes have a higher risk of developing oral candidiasis.
When blood sugar is poorly controlled, excess glucose appears in saliva, providing food for the yeast, and diabetes can weaken the immune system, making it harder for the body to fight off fungal infections. Symptoms of thrush include white patches on the tongue, inner cheeks, and throat; redness or soreness; difficulty swallowing; and a cottony feeling in the mouth. To prevent thrush if you have diabetes, it is essential to:
- Maintain good blood sugar control through medication adherence and lifestyle management
- Practice good oral hygiene
- Avoid smoking
- Limit sugar and alcohol consumption
If you develop thrush, antifungal medications like nystatin oral suspension, clotrimazole lozenges, or fluconazole tablets are typically prescribed, with treatment usually lasting 7-14 days depending on severity. The 2016 update by the infectious diseases society of America 1 provides the most recent and highest quality evidence for the management of candidiasis, and it is essential to follow these guidelines to prevent and treat thrush in people with diabetes.
From the Research
Diabetes and Thrush
- Diabetes mellitus (DM) is a chronic disease that can increase the susceptibility to infections, including thrush, due to a weakened immune system 2, 3.
- Candida species, which cause thrush, can become pathogenic in immunocompromised individuals, such as those with diabetes 2, 4.
- Uncontrolled hyperglycemia in diabetic patients can aggravate the susceptibility to Candida sp. infections 3.
- Diabetes can increase the vulnerability to various types of candidiasis, including oral, vulvovaginal, and cutaneous candidiasis 4.
Types of Candidiasis
- Oral candidiasis: diabetes can increase the risk of oral candidiasis, particularly in individuals with uncontrolled hyperglycemia 2, 4.
- Vulvovaginal candidiasis: diabetes can precipitate vulvovaginal candidiasis in females 4.
- Cutaneous candidiasis: diabetes can increase the risk of cutaneous candidiasis, including infections on the skin, nails, hands, and feet 4.
Treatment and Management
- Topical therapies, such as clotrimazole, nystatin, and miconazole, have been shown to be effective in treating cutaneous candidiasis, with complete cure rates of 73%-100% 5.
- Systemic therapies, such as oral fluconazole, can be effective in treating cutaneous candidiasis, particularly in cases where topical therapy is not sufficient 5.
- Prevention and management of diabetes can help reduce the risk of developing candidiasis, and early treatment can help prevent complications 2, 3, 4.