April 10, 2003
Other Medications
Question from Derby, England, United Kingdom:
I have hereditary spherocytosis diagnosed many years ago, had my gall bladder and spleen removed about two years ago, and about four months later, I developed type 1 diabetes. I was put on penicillin twice daily after operation, which is now down to once a day, but I decided would rather not take it at all. Is taking penicillin still necessary? Does diabetes put me at greater risk for infection?
Answer:
Having type 1 diabetes is just one more condition, in addition to your splenectomy, that puts you at increased risk for bacterial infections. However, the effect of the diabetes is dependent on your level of blood sugar control.
If your control is very good, you would have very little increase in risk above the baseline population, if you had a spleen. When the blood sugars go above 200 mg/dl [11.1 mmol/L], the high sugars inhibit the ability of the white blood cells to kill bacteria. If your blood sugars are well controlled, the lack of a spleen still puts you at risk for developing a serious bacterial infection.
JTL
