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Ahmed AE, Abdelkarim S, Zenida M, Baiti MAH, Alhazmi AAY, Alfaifi BAH, Majrabi RQM, Khormi NQM, Hakami AAA, Alqaari RAM, Alhasani RA, Alajam RA, Alshehri MM, Alenazi AM, Alqahtani B, Alshamrani M, Alhowimel A, Abdelwahab SI. Prevalence and Associated Risk Factors of Urinary Tract Infection among Diabetic Patients: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11060861. [PMID: 36981518 PMCID: PMC10048613 DOI: 10.3390/healthcare11060861] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
Urinary tract infections (UTIs) are one of the most common long-term complications of diabetes mellitus (DM). Additionally, various factors, such as socio-demographics, type of DM, fasting blood glucose, regular diabetes monitoring, comorbid chronic diseases, HbA1c, body mass index (BMI), and duration of DM, are also thought to predispose individuals to developing UTIs more frequently when they have DM. This research aims to evaluate the risk factors for UTIs and their prevalence among people with DM in Saudi Arabia (KSA). This cross-sectional study was conducted among 440 adults with type 1, type 2, and gestational DM. The participants had to be at least 18 years old, of both genders, and had been suffering from DM for any period of time. A self-administered questionnaire was utilized to collect data on demographic characteristics, such as sex, age, height, weight, material state, education level, income, and clinical profiles of DM and UTI. The crude (COR) and adjusted odds ratios (AOR) were calculated using logistic regression in the IBM SPSS software. The incidence of types 1 and 2 DM and gestational diabetes reached 34.1, 60.9, and 5%, respectively. Most of the participants had first-degree relatives with DM (65.9%). UTI was common in 39.3% of participants. A chi-squared statistical analysis revealed that the frequency of UTI varied depending (χ2 = 5.176, P = 0.023) on the type of DM. Burning urination and abdominal pain were the most common symptoms. The CORs for sex, marital status, hypertension, and BMI were significant (P < 0.05) and had values of 2.68 (95% CI = 1.78–4.02), 0.57 (95% CI = 0.36–0.92), 1.97 (95% CI = 1.14–3.43), and 2.83 (95% CI = 1.19–2.99), respectively. According to the adjusted model, only sex influenced the occurrence of UTIs. The AOR for sex was 3.45 (95% CI = 2.08–5.69). Based on this study, the authorities related to the health of DM patients can use its findings to guide awareness programs and clinical preparedness.
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Affiliation(s)
- Anas Elyas Ahmed
- Faculty of Medicine, Jazan University, Jazan GGGD6622, Saudi Arabia
| | | | - Maria Zenida
- Faculty of Medicine, Jazan University, Jazan GGGD6622, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Ramzi Abdu Alajam
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Mohammed M. Alshehri
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan GGGD6622, Saudi Arabia
- Medical Research Centre, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Aqeel M. Alenazi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Bader Alqahtani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Meshal Alshamrani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
| | - Ahmed Alhowimel
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan GGGD6622, Saudi Arabia
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Matthiopoulou G, Ioannou P, Mathioudaki A, Papadakis JA, Daraki VN, Pappas A, Souris S, Maraki S, Stathopoulou C, Kofteridis DP. Asymptomatic Bacteriuria in Patients with Type 2 Diabetes Mellitus. Infect Dis Rep 2023; 15:43-54. [PMID: 36648859 PMCID: PMC9887587 DOI: 10.3390/idr15010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
Objectives: Asymptomatic bacteriuria (ASB) is a common finding in patients with diabetes. Moreover, patients with diabetes and ASB have a greater risk for symptomatic urinary tract infections and associated severe complications. The aim of this study was to estimate the prevalence of ASB, as well as to identify independent risk factors and related pathogens associated with ASB in female and male patients with type 2 diabetes mellitus (T2D). Methods: This prospective case-control study was performed at the University hospital, and the Venezeleion General Hospital, Heraklion, Greece between 2012 and 2019. All patients with T2D attending the diabetes and hypertension outpatient clinics at both hospitals were enrolled, and data regarding their medical history and clinical and laboratory profiles were recorded. Asymptomatic patients with positive urine cultures were assigned as cases while those with negative urine cultures were designated as controls. Results: A total of 437 adult patients of which 61% were female and 39% were male patients with a mean age of 70.5 ± 9.6 years, were enrolled. The prevalence of ASB was 20.1%, in total. ASB was noted in 27% of female participants and 9.4% of male participants. Higher glycated hemoglobin (OR = 3.921, 95%CI: 1.521−10.109, p < 0.001) and urinary tract infection within the previous year (OR = 13.254, 95%CI: 2.245−78.241, p < 0.001) were independently positively associated with ASB, while higher levels of vitamin B12 were independently negatively associated with ASB (OR = 0.994 per ng/mL, 95%CI: 0.989−0.999, p < 0.001). Conclusions: Development of ASB was associated with specific factors, some of which may be modifiable. Interestingly, high B12 was found to be negatively associated with ASB.
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Affiliation(s)
- Georgia Matthiopoulou
- First Department of Internal Medicine, Venezeleion General Hospital of Heraklion, 714 09 Heraklion, Greece
- School of Medicine, University of Crete, 700 13 Heraklion, Greece
| | - Petros Ioannou
- School of Medicine, University of Crete, 700 13 Heraklion, Greece
- Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, 711 10 Heraklion, Greece
- Correspondence: (P.I.); (D.P.K.)
| | - Anna Mathioudaki
- Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, 711 10 Heraklion, Greece
| | - John A. Papadakis
- Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, 711 10 Heraklion, Greece
| | - Vasiliki N. Daraki
- Department of Endocrinology, University Hospital of Heraklion, 711 10 Heraklion, Greece
| | - Angelos Pappas
- Diabetes Unit, Venezeleion General Hospital of Heraklion, 714 09 Heraklion, Greece
| | - Sotiris Souris
- First Department of Internal Medicine, Venezeleion General Hospital of Heraklion, 714 09 Heraklion, Greece
| | - Sofia Maraki
- Department of Microbiology, University Hospital of Heraklion, 711 10 Heraklion, Greece
| | - Chrysoula Stathopoulou
- Laboratory of Rheumatology, Autoimmunity and Inflammation, Institute of Molecular Biology and Biotechnology, 700 13 Heraklion, Greece
| | - Diamantis P. Kofteridis
- School of Medicine, University of Crete, 700 13 Heraklion, Greece
- Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, 711 10 Heraklion, Greece
- Correspondence: (P.I.); (D.P.K.)
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Aamir AH, Raja UY, Qureshi FM, Asghar A, Mahar SA, Ahmed I, Ghaffar T, Zafar J, Hasan MI, Riaz A, Raza SA, Khosa IA, Khan J, Baqar JB. Safety and efficacy of Empagliflozin in Pakistani Muslim patients with type 2 diabetes (SAFE-PAK); a randomized clinical trial. BMC Endocr Disord 2022; 22:295. [PMID: 36443769 PMCID: PMC9703399 DOI: 10.1186/s12902-022-01213-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Sodium-Glucose-Co-Transporter 2 (SGLT2) inhibitor (Empagliflozin) is an effective drug in controlling blood glucose through predominantly glycosuria. Glycosuria increases the risk of genitourinary infections in diabetes. This study was aimed to establish the safety and efficacy of Empagliflozin (Group-A) versus standard care (Group-B) in Pakistani Muslim individuals with type 2 diabetes. METHODS A multicenter, randomized clinical trial was conducted in five cities across Pakistan from July 2019 to August 2020. Patients of both genders aged 18-75 years, body mass index (BMI) ≤ 45 kg/m2, glycosylated hemoglobin (HbA1c) 7-10% (53 mmol/mol to 86 mmol/mol) and treatment-naive to Empagliflozin were included. Treatment was given for 24 weeks, and allocation was done through randomization. RESULTS Out of 745 screened patients, 333 met the eligibility criteria, and a total of 244 (73.3%) patients were enrolled. More hypoglycemic events were reported in the standard care group, whereas positive urine culture, fungal infection, dehydration, and hypotension occurrence were comparable between the two groups. The 6 months mean HbA1c reduction was significant in both groups; (Group-A: 0.91 ± 0.15; p < 0.001 vs. Group-B2: 0.79 ± 0.14; p < 0.001). Efficacy comparison at 6 months revealed a significant reduction in weight and systolic blood pressure (SBP) in Group A only (Group-A: 1.4 ± 0.4 kg; p < 0.002 vs. Group-B: 0.01 ± 0.5 kg; p < 1.00), (Group-A: 5.1 ± 1.7 mmHg; p < 0.012 vs. Group-B: 2.3 ± 1.7 mmHg; p < 0.526). CONCLUSIONS Empagliflozin was a safe drug compared to standard care in Pakistani Muslim patients with diabetes. It was as effective as standard care in the clinical setting but achieved glycemic control by reducing weight and SBP in type 2 diabetes patients. TRIAL REGISTRATION This study was registered in the NIH US National Library of Medicine clinical trials registry at Clinicaltrials.gov with the registration number: NCT04665284 on 11/12/2020.
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Affiliation(s)
- Azizul Hasan Aamir
- Department of Diabetes, Endocrinology and Metabolic Diseases, Khyber Girls Medical College, Hayatabad Medical Complex, Peshawar, Pakistan.
- Post Graduate Medical Institute, Peshawar, Pakistan.
| | | | | | | | | | | | - Tahir Ghaffar
- Department of Diabetes, Endocrinology and Metabolic Diseases, Khyber Girls Medical College, Hayatabad Medical Complex, Peshawar, Pakistan
| | | | | | | | | | | | - Jahanzeb Khan
- Dow University of Health Sciences, Karachi, Pakistan
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Khalid F, Bushra R, Ghayas S, Mushtaque M. Case Report: Urinary Tract Infection in a Diabetic Postmenopausal Woman With Multiple Episodes of Recurrence: An Antimicrobial Susceptibility dispute. Clin Med Insights Case Rep 2022; 15:11795476221112819. [PMID: 35898804 PMCID: PMC9309758 DOI: 10.1177/11795476221112819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Urinary tract infection (UTI) is caused by bacteria growing in urine and affect
kidneys, bladder, ureters, and urethra. Women with diabetes are at high risk of
developing UTI. This is a case of a 60-year-old postmenopausal woman with
uncontrolled type-I diabetes mellitus and hypertension, who presented with an
acute onset of dysuria, burning micturition, and increased frequency. This case
highlights the shortfall in the preliminary management plan of performing
imperative clinical laboratory investigations including urine detailed report
(DR), urine culture and sensitivity(C/S), and plasma glucose testing to initiate
antimicrobial treatment. UTI requires to be treated precisely in diabetic
patients with the help of a comprehensive diagnosis for signs of dysuria,
frequent urination, and pelvic pain. The treatment of UTIs should always begin
with culture and sensitivity analysis while the patient is symptomatic, to
initiate antimicrobial treatment. Comorbidities should be managed appropriately
during treatment to achieve desired therapeutic outcomes.
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Affiliation(s)
- Farah Khalid
- Department of Pharmacy Practice, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
| | - Rabia Bushra
- Department of Pharmaceutics, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
| | - Sana Ghayas
- Department of Pharmaceutics, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Pakistan
| | - Madiha Mushtaque
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan
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Kesavadev J, Abraham G, Chandni R, Chawla P, Nambiar A, Deshpande N, Joshi S, Jothydev S, Krishnan G, Das AK. Type 2 Diabetes in Women: Differences and Difficulties. Curr Diabetes Rev 2022; 18:e081221198651. [PMID: 34879808 DOI: 10.2174/1573399818666211208110759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Lifestyle modification, along with medication, has improved the quality of life of patients with type 2 diabetes (T2D), but the treatment of diabetes in women still lacks a gender-centric approach. METHODS Expert opinions to improve diabetes management in women were collated from the open discussion forum organized by the sixth Jothydev's Professional Education Forum Diabetes Convention, which included global diabetes care experts and the general public. The review is also based on the studies published in electronic databases such as PubMed and Google Scholar that discussed the problems and challenges faced by the Indian diabetes care sector in treating women with diabetes. RESULTS The complex interplay of biological, socioeconomic, psychosocial, and physiological factors in women with type 2 diabetes has not been well addressed to date. Biological factors such as neurohumoral pathways, sex hormones, genetic predisposition as well as gender-based environmental and behavioural differences must be considered for modern personalized diabetes treatment. Most importantly, pregnant women with diabetes deserve special attention. This vulnerable phase has a marked impact on the future health of both the mother and the offspring. CONCLUSION The review provides an overview of the challenges and issues that exist in the clinical management of diabetes and its complications among women in India. Women-centric clinical approaches should be encouraged for the effective management of diabetes in Indian women.
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Affiliation(s)
- Jothydev Kesavadev
- Department of Diabetology, Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | - Georgi Abraham
- Madras Medical Mission Hospital, Chennai, Tamil Nadu, India
| | - R Chandni
- Department of Emergency Medicine, Government Medical College, Kozhikode, Kerala, India
| | - Purvi Chawla
- Lina Diabetes Care & Mumbai Diabetes Research Centre, Bhartia Arogya Nidhi Hospital, Mumbai, Maharashtra, India
| | - Anita Nambiar
- Gopal Clinic & Diabetic Care Centre, Tripunithura, Kerala, India
| | - Neeta Deshpande
- Belgaum Diabetes Centre, Children's Diabetes Centre and Weight Watch Centre, Belgaum, India
- Department of Medicine, MM Dental College, Belgaum, India
- 8USM-KLE International Medical Program, Belgaum, Karnataka, India
| | - Shilpa Joshi
- 8USM-KLE International Medical Program, Belgaum, Karnataka, India
| | - Sunitha Jothydev
- Department of Diabetology, Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | - Gopika Krishnan
- Department of Diabetology, Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | - Ashok Kumar Das
- Mumbai Diet and Health Centre, Mumbai, Maharashtra, India
- Pondicherry Institute of Medical Sciences, Pondicherry, Tamil Nadu, India
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