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Exploring the nexus: prevalence, risk factors, and clinical correlations of urinary tract infections in diabetes mellitus patients - a comprehensive retrospective analysis

Year 2024, , 93 - 96, 15.01.2024
https://doi.org/10.38053/acmj.1402336

Abstract

Aims: This study investigates the frequency and associated factors of urinary tract infections (UTIs) in patients with diabetes mellitus (DM).
Methods: This retrospective chart review focused on patients with diabetes mellitus. Data collection involved demographic details, DM diagnosis, comorbidities such as hypertension, hyperlipidemia, and coronary artery disease, along with medication usage. Laboratory values including blood glucose and HbA1c levels were also analyzed. The primary outcome of interest was the diagnosis of UTI, identified from clinical records.
Results: 173 DM patients were included in the study. These patients were divided into two groups according to the presence of UTI: 52 patients in the UTI group and 121 patients in the non-UTI group. The incidence of UTI was significantly higher in women (37.9%) compared to men (10.2%). No significant differences were observed between the groups in terms of age, presence of hypertension, hyperlipidemia, or coronary artery disease. Interestingly, the usage of SGLT-2 inhibitors was significantly higher in the UTI group compared to the non-UTI group (26.8% vs. 14%, p=0.043). No significant differences were found in other medication usage or in the levels of glucose and HbA1c between the groups.
Conclusion: The study highlights the increased risk of UTIs in DM patients, particularly among women and those using SGLT-2 inhibitors. These findings suggest the need for careful monitoring and tailored approaches in managing UTIs in DM patients, considering gender and specific DM treatments.

Ethical Statement

Additional permission for the study is attached as supplementary material.

Supporting Institution

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References

  • Hsia DS, Grove O, Cefalu WT. An update on sodium-glucose co-transporter-2 inhibitors for the treatment of diabetes mellitus. Curr Opin Endocrinol Diabetes Obes. 2017;24(1):73-79.
  • Liu J, Li L, Li S, et al. Effects of SGLT2 inhibitors on UTIs and genital infections in type 2 diabetes mellitus: a systematic review and meta-analysis. Sci Rep. 2017;7(1):2824.
  • Geerlings SE, Brouwer EC, Gaastra W, Verhoef J, Hoepelman AIM. Effect of glucose and pH on uropathogenic and non-uropathogenic Escherichia coli: studies with urine from diabetic and non-diabetic individuals. J Med Microbiol. 1999;48(6):535-539.
  • Petersmann A, Müller-Wieland D, Müller UA, et al. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes. 2019;127:S1-S7.
  • Lovic D, Piperidou A, Zografou I, Grassos H, Pittaras A, Manolis A. The growing epidemic of diabetes mellitus. Curr Vasc Pharmacol. 2020;18(2):104-109.
  • Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 dia- betes mellitus and its complications. Nat Rev Endocrinol. 2018;14:88-98.
  • Faselis C, Katsimardou A, Imprialos K, Deligkaris P, Kallistratos M, Dimitriadis K. Microvascular complications of type 2 diabetes mellitus. Curr Vasc Pharmacol. 2020;18(2):117-124.
  • Cloete L. Diabetes mellitus: an overview of the types, symptoms, complications and management. Nurs Stand. 2022;37(1):61-66.
  • Gupta K, Sahm DF, Mayfield D, Stamm WE. Antimicrobial resistance among uropathogens that cause community acquired urinary tract infections in women: a nationwide analysis. Clin Infect Dis. 2001;33(1):89-94.
  • Carrondo MC, Moita JJ. Potentially preventable urinary tract infection in patients with type 2 diabetes—a hospital-based study. Obes Med. 2020;17:100190.
  • Kamei J, Yamamoto S. Complicated urinary tract infections with diabetes mellitus. J Infect Chemother. 2021;27(8):1131-1136.
  • Al Qurabiy HE, Abbas IM, Hammadi AA, Mohsen FK, Salman RI, Dilfy SH. Urinary tract infection in patients with diabetes mellitus and the role of parental genetics in the emergence of the disease. J Med Life. 2022;15(8):955-962.
  • Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 diabetes and its impact on the immune system. Curr Diabetes Rev. 2020;16(5):442-449.
  • Nitzan O, Elias M, Chazan B, Saliba W. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and man- agement. Diabetes Metab Syndr Obes. 2015;8:129-136.
  • Gorter KJ, Hak E, Zuithoff NP, Hoepelman AI, Rutten GE. Risk of recurrent acute lower urinary tract infections and prescription pattern of antibiot- ics in women with and without diabetes in primary care. Fam Pract. 2010;27(4):379-385.
  • Zheng Z, He D, Chen J, et al. Risk of urinary tract infection in patients with type 2 diabetes mellitus treated with dapagliflozin: a systematic review and meta-analysis of randomized controlled trials. Clin Drug Investig. 2023;43(4):209-225.
  • Puckrin R, Saltiel MP, Reynier P, Azoulay L, Yu OHY, Filion KB. SGLT-2 inhibitors and the risk of infections: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol. 2018;55(5):503-514.
  • Merész G, Szabó S, Dóczy V, Hölgyesi Á, Szakács Z. A húgyúti fertőzések relatív gyakorisága metforminnal és SGLT2-gátlóval kezelt 2-es típusú diabetes mellitusban szenvedő betegekben. Hálózati metaanalízis. Orv Hetil. 2020;161(13):491-501.
  • Bodke H, Wagh V, Kakar G. Diabetes mellitus and prevalence of other comorbid conditions: a systematic review. Cureus. 2023;15(11):e49374.
  • Liu F, Ling Z, Xiao Y, et al. Alterations of urinary microbiota in type 2 diabetes mellitus with hypertension and/or hyperlipidemia. Front Physiol. 2017;8:126. doi:10.3389/fphys. 2017.00126
Year 2024, , 93 - 96, 15.01.2024
https://doi.org/10.38053/acmj.1402336

Abstract

References

  • Hsia DS, Grove O, Cefalu WT. An update on sodium-glucose co-transporter-2 inhibitors for the treatment of diabetes mellitus. Curr Opin Endocrinol Diabetes Obes. 2017;24(1):73-79.
  • Liu J, Li L, Li S, et al. Effects of SGLT2 inhibitors on UTIs and genital infections in type 2 diabetes mellitus: a systematic review and meta-analysis. Sci Rep. 2017;7(1):2824.
  • Geerlings SE, Brouwer EC, Gaastra W, Verhoef J, Hoepelman AIM. Effect of glucose and pH on uropathogenic and non-uropathogenic Escherichia coli: studies with urine from diabetic and non-diabetic individuals. J Med Microbiol. 1999;48(6):535-539.
  • Petersmann A, Müller-Wieland D, Müller UA, et al. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes. 2019;127:S1-S7.
  • Lovic D, Piperidou A, Zografou I, Grassos H, Pittaras A, Manolis A. The growing epidemic of diabetes mellitus. Curr Vasc Pharmacol. 2020;18(2):104-109.
  • Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 dia- betes mellitus and its complications. Nat Rev Endocrinol. 2018;14:88-98.
  • Faselis C, Katsimardou A, Imprialos K, Deligkaris P, Kallistratos M, Dimitriadis K. Microvascular complications of type 2 diabetes mellitus. Curr Vasc Pharmacol. 2020;18(2):117-124.
  • Cloete L. Diabetes mellitus: an overview of the types, symptoms, complications and management. Nurs Stand. 2022;37(1):61-66.
  • Gupta K, Sahm DF, Mayfield D, Stamm WE. Antimicrobial resistance among uropathogens that cause community acquired urinary tract infections in women: a nationwide analysis. Clin Infect Dis. 2001;33(1):89-94.
  • Carrondo MC, Moita JJ. Potentially preventable urinary tract infection in patients with type 2 diabetes—a hospital-based study. Obes Med. 2020;17:100190.
  • Kamei J, Yamamoto S. Complicated urinary tract infections with diabetes mellitus. J Infect Chemother. 2021;27(8):1131-1136.
  • Al Qurabiy HE, Abbas IM, Hammadi AA, Mohsen FK, Salman RI, Dilfy SH. Urinary tract infection in patients with diabetes mellitus and the role of parental genetics in the emergence of the disease. J Med Life. 2022;15(8):955-962.
  • Berbudi A, Rahmadika N, Tjahjadi AI, Ruslami R. Type 2 diabetes and its impact on the immune system. Curr Diabetes Rev. 2020;16(5):442-449.
  • Nitzan O, Elias M, Chazan B, Saliba W. Urinary tract infections in patients with type 2 diabetes mellitus: review of prevalence, diagnosis, and man- agement. Diabetes Metab Syndr Obes. 2015;8:129-136.
  • Gorter KJ, Hak E, Zuithoff NP, Hoepelman AI, Rutten GE. Risk of recurrent acute lower urinary tract infections and prescription pattern of antibiot- ics in women with and without diabetes in primary care. Fam Pract. 2010;27(4):379-385.
  • Zheng Z, He D, Chen J, et al. Risk of urinary tract infection in patients with type 2 diabetes mellitus treated with dapagliflozin: a systematic review and meta-analysis of randomized controlled trials. Clin Drug Investig. 2023;43(4):209-225.
  • Puckrin R, Saltiel MP, Reynier P, Azoulay L, Yu OHY, Filion KB. SGLT-2 inhibitors and the risk of infections: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol. 2018;55(5):503-514.
  • Merész G, Szabó S, Dóczy V, Hölgyesi Á, Szakács Z. A húgyúti fertőzések relatív gyakorisága metforminnal és SGLT2-gátlóval kezelt 2-es típusú diabetes mellitusban szenvedő betegekben. Hálózati metaanalízis. Orv Hetil. 2020;161(13):491-501.
  • Bodke H, Wagh V, Kakar G. Diabetes mellitus and prevalence of other comorbid conditions: a systematic review. Cureus. 2023;15(11):e49374.
  • Liu F, Ling Z, Xiao Y, et al. Alterations of urinary microbiota in type 2 diabetes mellitus with hypertension and/or hyperlipidemia. Front Physiol. 2017;8:126. doi:10.3389/fphys. 2017.00126
There are 20 citations in total.

Details

Primary Language English
Subjects Infectious Diseases, Clinical Microbiology
Journal Section Research Articles
Authors

Meltem Karslıoğlu 0000-0001-8490-3757

Merve Olpak Yılmaz 0009-0009-7974-4056

Publication Date January 15, 2024
Submission Date December 8, 2023
Acceptance Date January 11, 2024
Published in Issue Year 2024

Cite

AMA Karslıoğlu M, Olpak Yılmaz M. Exploring the nexus: prevalence, risk factors, and clinical correlations of urinary tract infections in diabetes mellitus patients - a comprehensive retrospective analysis. Anatolian Curr Med J / ACMJ / acmj. January 2024;6(1):93-96. doi:10.38053/acmj.1402336

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