LISA CLARK: I'm Lisa Clark. Welcome and thanks for joining us for this webcast.
Yeast infections are a problem every woman should be aware of. Studies show that nearly three out of every four women will experience this condition at least once. But women with diabetes are at even higher risk and it's even more important for them to keep in contact with their doctors. Today we'll find out the link between diabetes and yeast infections and what extra precautions women with diabetes should take for prevention and for treatment.
Joining me to discuss this topic we have two gynecologists: Dr. Gloria Bachmann, welcome.
GLORIA BACHMANN, MD: Thank you.
LISA CLARK: Dr. Joseph Apuzzio, welcome to you. And also diabetes specialist Dr. Gerald Bernstein. Thank you all for being here.
I want to start with the link between diabetes and yeast infections, Dr. Bernstein. Why does diabetes increase the risk for developing these?
GERALD BERNSTEIN, MD: It's important to understand what an elevated blood glucose will do. When the blood sugar elevates, two things happen. One, all the body secretions will have an increased amount of glucose. Two, all of the tissues of the body stop functioning normally, and therefore the normal defenses that the body has against intrusion by outside substances -- such as yeast -- will be abnormal.
LISA CLARK: Is the risk different between patients who have Type I and Type II diabetes? And if so, how?
GERALD BERNSTEIN, MD: No, it's not different. An elevated blood sugar is basically acting like a poison. And it will poison both Type I and Type II patients if the glucose is not controlled.
LISA CLARK: Obviously, it's important for any diabetic to control blood sugar. But what are the target blood sugars for women that will make them a little bit safer from developing yeast infections?
GERALD BERNSTEIN, MD: Well, we make a diagnosis of diabetes when the blood sugar is above 126. Our goals are to have the morning and before-meal blood sugar around 100-110 and then, after a meal, no more than 140. Now that's what the normal is. What we have found is that when we extended that, that people developed problems. So we aim for the normal numbers.
LISA CLARK: Dr. Bachman, how about some other general prevention tips to avoid developing a yeast infection?
GLORIA BACHMANN, MD: Well Lisa, let me start by saying that many women who have a yeast infection automatically assume that they're diabetic. The reality is that most are not diabetic. That yeast infections come from lots of reasons. Antibiotic use can cause yeast infections, wet bathing suits for long periods of time can cause yeast infections, oral contraceptive pills can cause yeast infections so there are many other causes.
LISA CLARK: If a woman with diabetes thinks that she has a yeast infection, what should she do? Dr. Apuzzio?
JOSEPH APUZZIO, MD: Well, I think the first thing she should do is visit her doctor to make a diagnosis. The diagnosis is really crucial.
LISA CLARK: And there are certain tests that she should make sure her doctor performs. Is that correct?
JOSEPH APUZZIO, MD: Yes. What I would say is, in order to make a diagnosis, one should do a slide test under the microscope of vaginal secretions to see if one sees the yeast organism that causes the infection. Usually that will suffice. Sometimes one also has to culture the vaginal secretions as well, but that's in a small number of patients. Most patients, one can make the diagnosis with the slide test under the microscope.
GLORIA BACHMANN, MD: Lisa, it's really important for women to come in before they douche or before they start treatment for the first infection, so that we can see exactly what the vaginal health looks like and make the appropriate diagnosis.
LISA CLARK: Dr. Bachmann, what treatment options for a diabetic woman with a yeast infection?
GLORIA BACHMANN, MD: A diabetic woman, Lisa, can use all the same treatment options that a woman who does not have diabetes can use. That if she prefers oral, she can use oral. If she prefers a vaginal treatment, she can use a vaginal treatment.
LISA CLARK: Do yeast infections in women take longer to treat in some cases?
JOSEPH APUZZIO, MD: There is many therapies that one could use. One-day therapies, three-day therapies, seven-days or fourteen-days. And usually, patients who are diabetic need the longer therapy, not the shorter.
I think one of the mistakes that I see is a patient who has diabetes given a one-day or a three-day therapy. It's probably not going to be as effective as having a seven- or fourteen-day therapy. I think that's very important.
LISA CLARK: Is there a benefit to topical verses pill?
JOSEPH APUZZIO, MD: Well, patients can be allergic to either. Also there's the potential for drug interactions if one is taking a medication on a long-term basis. So for example, for chronic recurrent disease many individuals would prefer a topical therapy rather than the oral because the oral could interfere with some of the medications that the patient is taking.
LISA CLARK: Dr. Bachmann, I know that there are a lot of products will bill themselves as sort of an over-the-counter treatment, diagnose and treat yourself. Is that advisable, especially for women with diabetes who develop a yeast infection?
GLORIA BACHMANN, MD: It's advisable, Lisa, once the woman knows what she's dealing with. That she's seen her physician, that she knows the symptoms, the physician has looked at the vaginal secretions and confirmed -- under the microscope -- that indeed she has a yeast infection and that she certainly can treat recurrent ones when she understands what a yeast infection is, what it feels like.
LISA CLARK: Any additional thoughts that you'd like to add?
GLORIA BACHMANN, MD: I think the other important issue is to complete your therapy. Many women will come in and say to me, "You know what? I finished sooner than I should of according to the package, because I felt better." And I think it's important to complete the complete therapy and not stop midway.
The other is if a woman still feels that she has symptoms, they haven't gone away completely, then that's time to go back to the doctor and again go through the full evaluation of having a pelvic examination, having the physician look at the secretions under the microscope to be sure that the infection has been resolved with the medication.
LISA CLARK: So bottom line, start with a doctor and make sure that your doctor knows -- when you've completed treatment -- that the infection is gone.
GLORIA BACHMANN, MD: Exactly.
LISA CLARK: All right. Thanks all of you for joining us; we really appreciate your time. And thanks to all of you in our web audience. I'm Lisa Clark.
Yeast infections are a problem every woman should be aware of. Studies show that nearly three out of every four women will experience this condition at least once. But women with diabetes are at even higher risk and it's even more important for them to keep in contact with their doctors. Today we'll find out the link between diabetes and yeast infections and what extra precautions women with diabetes should take for prevention and for treatment.
Joining me to discuss this topic we have two gynecologists: Dr. Gloria Bachmann, welcome.
GLORIA BACHMANN, MD: Thank you.
LISA CLARK: Dr. Joseph Apuzzio, welcome to you. And also diabetes specialist Dr. Gerald Bernstein. Thank you all for being here.
I want to start with the link between diabetes and yeast infections, Dr. Bernstein. Why does diabetes increase the risk for developing these?
GERALD BERNSTEIN, MD: It's important to understand what an elevated blood glucose will do. When the blood sugar elevates, two things happen. One, all the body secretions will have an increased amount of glucose. Two, all of the tissues of the body stop functioning normally, and therefore the normal defenses that the body has against intrusion by outside substances -- such as yeast -- will be abnormal.
LISA CLARK: Is the risk different between patients who have Type I and Type II diabetes? And if so, how?
GERALD BERNSTEIN, MD: No, it's not different. An elevated blood sugar is basically acting like a poison. And it will poison both Type I and Type II patients if the glucose is not controlled.
LISA CLARK: Obviously, it's important for any diabetic to control blood sugar. But what are the target blood sugars for women that will make them a little bit safer from developing yeast infections?
GERALD BERNSTEIN, MD: Well, we make a diagnosis of diabetes when the blood sugar is above 126. Our goals are to have the morning and before-meal blood sugar around 100-110 and then, after a meal, no more than 140. Now that's what the normal is. What we have found is that when we extended that, that people developed problems. So we aim for the normal numbers.
LISA CLARK: Dr. Bachman, how about some other general prevention tips to avoid developing a yeast infection?
GLORIA BACHMANN, MD: Well Lisa, let me start by saying that many women who have a yeast infection automatically assume that they're diabetic. The reality is that most are not diabetic. That yeast infections come from lots of reasons. Antibiotic use can cause yeast infections, wet bathing suits for long periods of time can cause yeast infections, oral contraceptive pills can cause yeast infections so there are many other causes.
LISA CLARK: If a woman with diabetes thinks that she has a yeast infection, what should she do? Dr. Apuzzio?
JOSEPH APUZZIO, MD: Well, I think the first thing she should do is visit her doctor to make a diagnosis. The diagnosis is really crucial.
LISA CLARK: And there are certain tests that she should make sure her doctor performs. Is that correct?
JOSEPH APUZZIO, MD: Yes. What I would say is, in order to make a diagnosis, one should do a slide test under the microscope of vaginal secretions to see if one sees the yeast organism that causes the infection. Usually that will suffice. Sometimes one also has to culture the vaginal secretions as well, but that's in a small number of patients. Most patients, one can make the diagnosis with the slide test under the microscope.
GLORIA BACHMANN, MD: Lisa, it's really important for women to come in before they douche or before they start treatment for the first infection, so that we can see exactly what the vaginal health looks like and make the appropriate diagnosis.
LISA CLARK: Dr. Bachmann, what treatment options for a diabetic woman with a yeast infection?
GLORIA BACHMANN, MD: A diabetic woman, Lisa, can use all the same treatment options that a woman who does not have diabetes can use. That if she prefers oral, she can use oral. If she prefers a vaginal treatment, she can use a vaginal treatment.
LISA CLARK: Do yeast infections in women take longer to treat in some cases?
JOSEPH APUZZIO, MD: There is many therapies that one could use. One-day therapies, three-day therapies, seven-days or fourteen-days. And usually, patients who are diabetic need the longer therapy, not the shorter.
I think one of the mistakes that I see is a patient who has diabetes given a one-day or a three-day therapy. It's probably not going to be as effective as having a seven- or fourteen-day therapy. I think that's very important.
LISA CLARK: Is there a benefit to topical verses pill?
JOSEPH APUZZIO, MD: Well, patients can be allergic to either. Also there's the potential for drug interactions if one is taking a medication on a long-term basis. So for example, for chronic recurrent disease many individuals would prefer a topical therapy rather than the oral because the oral could interfere with some of the medications that the patient is taking.
LISA CLARK: Dr. Bachmann, I know that there are a lot of products will bill themselves as sort of an over-the-counter treatment, diagnose and treat yourself. Is that advisable, especially for women with diabetes who develop a yeast infection?
GLORIA BACHMANN, MD: It's advisable, Lisa, once the woman knows what she's dealing with. That she's seen her physician, that she knows the symptoms, the physician has looked at the vaginal secretions and confirmed -- under the microscope -- that indeed she has a yeast infection and that she certainly can treat recurrent ones when she understands what a yeast infection is, what it feels like.
LISA CLARK: Any additional thoughts that you'd like to add?
GLORIA BACHMANN, MD: I think the other important issue is to complete your therapy. Many women will come in and say to me, "You know what? I finished sooner than I should of according to the package, because I felt better." And I think it's important to complete the complete therapy and not stop midway.
The other is if a woman still feels that she has symptoms, they haven't gone away completely, then that's time to go back to the doctor and again go through the full evaluation of having a pelvic examination, having the physician look at the secretions under the microscope to be sure that the infection has been resolved with the medication.
LISA CLARK: So bottom line, start with a doctor and make sure that your doctor knows -- when you've completed treatment -- that the infection is gone.
GLORIA BACHMANN, MD: Exactly.
LISA CLARK: All right. Thanks all of you for joining us; we really appreciate your time. And thanks to all of you in our web audience. I'm Lisa Clark.