Diabetes Forecast

How To Spot and Prevent Yeast Infections

By Allison Tsai , ,

Haleigh Eason/Mittera (illustrations); Thinkstock (patterns)

Yeast infections rate anywhere from annoying to unbearable, yet many people avoid broaching the topic with their doctor. But don’t let embarrassment stop you from raising the issue with your health care provider, particularly if you’re getting these infections frequently. 

Spotting Symptoms

Yeast infections occur when the fungus Candida albicans grows out of control, says Deena Adimoolam, MD, assistant professor of diabetes, endocrinology, and bone disease at the Icahn School of Medicine at Mount Sinai in New York. The overgrowth of yeast can occur anywhere on the body, though for women, these infections typically affect the vagina. It’s less common, but men can develop yeast infections, too. “You can even have yeast infections that affect certain areas of the skin, especially in skin folds, where it’s very moist and warm,” she says.

The symptoms of a vaginal yeast infection include itching, burning, pain, and a cottage cheese–like discharge. Signs of a skin yeast infection are a bit different. “It can appear as a slight discoloration of the skin or a red or pink scaly rash,” says Adimoolam, who notes that such infections may be itchy.

Risky Business

Women with poorly controlled diabetes are at high risk for yeast infections because candida thrives on higher-than-normal glucose levels, says Pauline Camacho, MD, FACE, professor of medicine at Loyola University Medical Center in Chicago. Women on SGLT-2 inhibitors are also at increased risk. Men with elevated glucose have a greater risk than people without diabetes for developing yeast infections. 

Looking Inward

While it’s clear that high blood glucose allows yeast to thrive, researchers are still looking at why this is the case. The answer may lie with the immune system (uncontrolled diabetes hinders the body’s ability to fight infection) or the medications you take.

Immune Evasion

One theory for why yeast infections come back is that candida produces a protein that allows it to adhere better than other fungi and bacteria to the vaginal lining and evade the immune system, says Adimoolam. The result? Recurrent infections when blood glucose is high.  

Blunt Response

Immune cells called neutrophils defend the body against disease, but they’re compromised in people with poorly controlled diabetes. Some studies show that these cells have defects in movement and show altered chemical processes involved in destroying infections—such as candida. T cells are another infection-fighting heavyweight in our immune system, but high blood glucose may weaken their ability to attack. Adimoolam says the reason is not yet clear.

Side Effects

Yeast infections can thrive for reasons unrelated to diabetes. Prolonged or repeated antibiotic use can disrupt the balance of good bacteria and yeast in the vaginal area (also known as normal flora) that suppress the growth of bad bacteria and yeast. As the bacteria that keep candida in check die, the yeast spreads out of control, says Adimoolam. Older, postmenopausal women are at increased risk for yeast infections because they produce less estrogen. Women using certain contraceptives, such as vaginal sponges and diaphragms, also have a higher risk. These have been shown to disrupt vaginal flora and boost yeast growth. People taking immunosuppressive medications—such as those that prevent rejection of organ transplants—are more likely to get infections.

Treating Infections

Over-the-counter creams for vaginal infections and infections of the skin can help treat a yeast infection early on, says Camacho. But if it doesn’t clear up after a few days or if you’ve had several yeast infections in a short time, Camacho recommends that you talk with your health care provider. An oral antifungal medication will probably be prescribed.

Keeping your blood glucose within target range can prevent a recurrence. “These organisms tend to thrive when sugars are the highest,” Adimoolam says.

Yeast Prevention

Four simple lifestyle changes can help you fend off yeast infections.

  1. Wear breathable fabrics. Yeast thrives in warm environments, so make sure your vaginal area has enough airflow. Opt for cotton underwear and avoid tight-fitting undergarments and panty hose. “Allow for as much airflow as possible,” says Deena Adimoolam, MD, assistant professor of diabetes, endocrinology, and bone disease at the Icahn School of Medicine at Mount Sinai in New York.

  2. Follow proper hygiene. After going to the bathroom, wipe front to back. Wash yourself frequently. Keep your genitals and the area under skin folds dry and clean. “It’s all about controlling moisture,” says Pauline Camacho, MD, FACE, president of the American Association of Clinical Endocrinologists.

  3. Choose condoms wisely. Those with spermicide can lead to yeast infections in some women.

  4. Avoid douches and scented sanitary products. They can change the pH of the vagina, which can upset the healthy balance of vaginal bacteria and make yeast infections more likely.


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