Diabetes Mellitus Type-02 = Relation with Black Fungal Disease (Mucormycosis) & White Fungal Disease

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Type 2 Diabetes Mellitus
In type 2 diabetes (formerly called non– insulin-dependent diabetes or adult-onset diabetes), the pancreas often continues to produce insulin, sometimes even at higher-than-normal levels, especially early in the disease. However, the body develops resistance to the effects of insulin, so there is not enough insulin to meet the body’s needs. As type 2 diabetes progresses, the insulin-producing ability of the pancreas decreases.

Complications of diabetes
(1) Brain, causing a stroke
(2) Eyes (diabetic retinopathy), causing blindness
(3) Heart, causing a heart attack
(4) Kidneys (diabetic nephropathy), causing chronic kidney disease
(5) Nerves (diabetic neuropathy), causing a decreased sensation in feet

Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection caused by a group of molds called mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people who have health problems or take medicines that lower the body’s ability to fight germs and sickness. It most commonly affects the sinuses or the lungs after inhaling fungal spores from the air. It can also occur on the skin after a cut, burn, or another type of skin injury.

Warning signs include pain and redness around the eyes or nose, with fever, headache, coughing, shortness of breath, bloody vomits, and altered mental status. According to the advisory, infection with mucormycetes should be suspected when there is:

(1) Sinusitis — nasal blockade or congestion, nasal discharge (blackish/bloody);
(2) Local pain on the cheekbone, one-sided facial pain, numbness or swelling;
(3) Blackish discoloration over bridge of nose/palate;
(4) Loosening of teeth, jaw involvement;
(5) Blurred or double vision with pain;
(6) Thrombosis, necrosis, skin lesion;
(7) Chest pain, pleural effusion, worsening of respiratory symptoms.

While it is treated with antifungals, mucormycosis may eventually require surgery. Doctors have said that it is of utmost importance to control diabetes, reduce steroid use, and discontinue immunomodulating drugs. To maintain adequate systemic hydration, the treatment includes infusion of normal saline (IV) before infusion of amphotericin B and antifungal therapy, for at least 4-6 weeks.

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