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This second article on skin conditions in diabetes looks at skin infections in diabetes and diabetes foot
ulceration. By David Morris

People with diabetes are at greater risk of skin infections through a variety of mechanisms. Hyperglycaemia produces an environment favourable for proliferation of micro-organisms. Neutrophil phagocytic activity and lymphocytic function are impaired in those with diabetes. Antibody effectiveness can be compromised by glycation of immunoglobulins (glucose molecules attaching to proteins) secondary to hyperglycaemia. The antioxidant system in those with diabetes is suppressed rendering cells more susceptible to oxidative stress damage from free radicals and less capable of responding to infection.1

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Bacterial infections 

Bacterial infections are both more frequent and of greater severity in individuals with diabetes. Staphylococcus aureus is the most commonly implicated organism, causing boils and abscesses, typically through infection of hair follicles. Effective anti-staphylococcal antibiotics include flucloxacillin, clarithromycin and doxycycline. Abscesses may require surgical drainage.

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