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People need to understand that it is not often the disease that can cause them to get very sick and possibly die, but it is the subsequent fungal infections that they need to watch out for. Molds that can be found both indoors and outdoors can infect people, and especially with compromised immune systems such as people with diabetes.

For example, patients with diabetic ketoacidosis (DKA) are uniquely predisposed to a fungal infection called mucormycosis, with high mortality. A new May 2016 study published in the Journal of Clinical Investigation shows that a natural treatment of sodium bicarbonate, AKA baking soda, may help prevent the spread of mucormycosis in patients with DKA.

The study found sodium bicarbonate reversed the effects that promoted the spread of mucormycosis in DKA, a life-threatening condition that can affect people with diabetes.(1) Diabetic ketoacidosis (DKA) is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin.

Fat is used for fuel instead. When fat is broken down to fuel the body, chemicals called ketones build up in the body. In high levels, ketones are poisonous. This condition is known as ketoacidosis. A state of absolute or relative insulin deficiency resulting in hyperglycemia, dehydration and accumulation of ketone bodies in the blood with subsequent metabolic acidosis (pH < 7.30; serum bicarbonate < 15 mmol/L).(2)

Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection caused by a group of molds called mucormycetes.(CDC) Many different species of fungi can cause mucormycosis. They belong to a large group of molds called Mucorales. These molds include Rhizopus, Rhizomucor, Absidia, and Mucor. Each species causes similar symptoms. These molds are common in the environment and include many common bread molds.(Merck Manual)

It is an aggressive, frequently fatal invasive fungal infection that can develop in immunocompromised patients because of impaired host defense mechanism and increased availability of micronutrients such as iron. It is usually documented in patients with uncontrolled diabetes with diabetic ketoacidosis (DKA). Depending upon the severity and extent of the spread it may involve the upper respiratory, ocular and intracranial regions.

Current treatment options such as surgery and antifungal drugs like amphotericin B, Isavuconazole, and posaconazole are not very effective in treating mucormycosis. The mortality rate is higher than 40%, and approaches 100% in patients with hematogenously disseminated disease, prolonged neutropenia, and brain involvement.

“The current guidelines for correcting acidosis of DKA patients doesn’t indicate using sodium bicarbonate until the acidosis is severe,” said Ashraf S. Ibrahim, PhD, an LA BioMed lead researcher and corresponding author of the study. “Our data strongly suggest that DKA patients suspected of having mucormycosis would benefit from adding sodium bicarbonate to the treatment regimen — regardless of whether they have severe acidosis or not — because sodium bicarbonate is likely to halt the growth of the fungus.”

Their finding of elevated iron levels also suggested that reducing the amount of iron by the use of iron chelation, in conjunction with sodium bicarbonate treatment, would help prevent mucormycosis infections in patients with DKA. The researchers also noted that further studies are needed in well-designed clinical trials involving patients with DKA and mucormycosis infections.(1)


  1. Eurek Alert
  2. Journal of Clinical Investigation

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