Learn About Lyme Disease: Are You at Risk?

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Learn About Lyme Disease: Are You at Risk?

You’ve probably heard of Lyme disease, and maybe you’ve even had it. What exactly is Lyme disease, and what causes it? And does having diabetes put you at risk?

What is Lyme disease?

The Lyme Disease Association defines Lyme disease as “a bacterial disease which, in the U.S., is caused by the bacteria Borrelia burgdorferi or newly discovered Borrelia mayonnii.” These bacteria can attack any system in the body and produce different Lyme disease symptoms.

What causes Lyme disease?

A bacterial infection that causes Lyme disease results from the bite of an infected tick. Ticks that spread the bacteria are blacklegged ticks, commonly known as deer ticks. These ticks are usually found in these parts of the United States:

  • Northeast
  • Mid-Atlantic
  • Upper Midwest
  • Pacific coast, especially northern California

Ticks can attach themselves to any part of the body, but they are notorious for hiding out in hard-to-see areas such as the scalp, groin, and armpits. In most cases, says the CDC (Centers for Disease Control and Prevention), a tick must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted.

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Who is at risk for Lyme disease?

Anyone of any age can get a tick bite. People who spend a lot of time outdoors in woody, grassy areas are at a higher risk — this includes campers, hikers, and people who work in parks, gardens, and forests. While most tick bites tend to happen during summer months when ticks are most active and the weather is fine, you can get a tick bite in the fall or even in the winter if the weather is mild.

What are signs and symptoms of Lyme disease?

Lyme disease signs and symptoms can appear in stages.

Early signs and symptoms (three to 30 days after a tick bite) include:

  • A small, red bump that looks like a mosquito bite.
  • A red rash that may be clear in the middle, like a bull’s eye pattern. The rash may spread and be warm to the touch, although it’s usually not itchy.
  • Fever or chills.
  • Headache or body aches.
  • Fatigue.
  • Swollen lymph nodes

Later signs and symptoms (days to month after a tick bite) include:

  • Severe headaches and neck stiffness.
  • A rash that appears on other parts of the body.
  • Joint pain and swelling, especially in the knees.
  • Facial palsy, which causes drooping on one or both sides of the face.
  • Heart palpitations or an irregular heartbeat (Lyme carditis).
  • Dizziness or shortness of breath.
  • Nerve pain, or numbness or tingling in your limbs.

Why might people with diabetes have a higher risk of Lyme disease?

A study published in 2016 in the journal PLoS One found that hyperglycemia (high blood sugar) inhibited the action of neutrophils in mice. Neutrophils are a type of white blood cell that fight infection by ingesting and killing microorganisms (including bacteria).

Hyperglycemia was induced in these mice, and they were infected with B. burgdorferi, which causes Lyme disease. The researchers found that the high blood sugars impaired the neutrophil response to the bacterium. As a result, the bacterium colonized in other parts of the mice’s bodies, including the brain, heart, liver, lungs, and knee joints.

It’s important to note that this study does not necessarily apply to humans with diabetes, and more research is obviously needed. However, diabetes can impact the immune system and increase the risk of different types of illness and infection.

How is Lyme disease diagnosed?

If you have had a tick bite and develop symptoms, or even if you aren’t sure if you have a tick bite but develop symptoms, you should see your health care provider promptly. Untreated Lyme disease can lead to serious complications, including arthritis, neurological problems, and cognitive issues, such as impaired memory and change in mood.

Blood tests are used to diagnose Lyme disease by measuring antibody levels that are produced in response to the disease. The CDC recommends a two-test process.

  • If the first test result is negative, you don’t need further testing.
  • If the first test result is positive, your blood will have a second test.
  • If both results are positive and you also have symptoms, you likely have Lyme disease. If you don’t have symptoms, you might have an autoimmune disease, such as lupus or rheumatoid arthritis.

How is Lyme disease treated?

Lyme disease is treated with antibiotics: doxycycline, amoxicillin, or cefuroxime are typically used. Oral antibiotics are prescribed for early stages of Lyme; later stages may require intravenous antibiotics.

Most cases of Lyme disease are cured with a two- to four-week course of antibiotics, but some people have symptoms of pain, fatigue, or difficulty thinking that lasts for more than six months after their first treatment. This is called Post-Treatment Lyme Disease Syndrome (PTLDS). It’s not clear why this happens, and there is no proven treatment for it. People with PTLDS usually get better over time, but if you have been treated for Lyme and still don’t feel well afterwards, talk with your provider to discuss other treatment options.

How can you prevent Lyme disease?

You can take steps to prevent getting tick bites. Steps include:

  • Treating clothing and camping gear with products that contain 0.5% permethrin.
  • Avoiding wooded areas with high grass and leaf litter.
  • Wearing long-sleeved shirts and long pants; tuck your pants into socks or boots, and shirts into pants. Light-colored clothing will help you more easily spot ticks.
  • Avoid sitting directly on the ground or on stone walls.
  • Check clothes and exposed skin often for ticks while you’re outdoors, and again when you’re indoors.

For more information about preventing tick bites, including how to remove a tick should you get a bite, visit the CDC’s website.

Want to learn about other causes of fatigue? Read “Feeling Fatigued? Here’s How to Fight It” and “What Causes Diabetes Fatigue?”

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES

Amy Campbell, MS, RD, LDN, CDCES on social media

A Registered Dietitian and Certified Diabetes Educator at Good Measures, LLC, where she is a CDE manager for a virtual diabetes program. Campbell is the author of Staying Healthy with Diabetes: Nutrition & Meal Planning, a co-author of 16 Myths of a Diabetic Diet, and has written for  publications including Diabetes Self-Management, Diabetes Spectrum, Clinical Diabetes, the Diabetes Research & Wellness Foundation’s newsletter,, and

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