Prevalence and incidence of urinary tract and genital infections among patients with and without type 2 diabetes

J Diabetes Complications. 2017 Nov;31(11):1587-1591. doi: 10.1016/j.jdiacomp.2017.07.018. Epub 2017 Aug 3.

Abstract

Objective: Epidemiological data on genitourinary infections (GUIs) comparing patients with and without type 2 diabetes (T2DM) is scant. We aimed to estimate the incidence of urinary tract infections (UTIs), genital infections (GIs), or any GUI in total and stratified by history of GUI and sex.

Research design and methods: We identified 39,295 patients in the Kaiser Permanente Northwest health plan with T2DM and an equal number of age and sex matched patients without diabetes. The cohort was followed for up to 9years (2006-2014). We calculated incidence rates and corresponding 95% confidence intervals (CI) of any GUI, UTIs and GIs adjusting for age, sex, race, BMI, presence of chronic kidney disease, annual number of outpatient visits, and diuretic use.

Results: Adjusted incidence of any GUI was 97.2/1000person-years (p-y) (95% CI 95.5-98.8) among the T2DM cohort vs. 79.7/1000 p-y (78.3-81.2) among those without diabetes. T2DM was associated with an adjusted 25% increased risk of UTI (rate ratio 1.25, 95% CI 1.22-1.29), a 26% increased risk of GI (1.26, 1.22-1.31) and a 22% increased risk of any GUI (1.22, 1.19-1.25). Incidence rates were lower among those with no GUI history, but the relative risks were similar. Women in both groups had higher incidence rates of GUIs than men.

Conclusions: T2DM was associated with increased risks of any GUI, UTIs and GIs. Incidence rates of UTIs were higher than rates of GIs, but the relative risk of GIs was essentially identical. A similar pattern was observed when stratifying by sex.

Significance of the study: RESEARCH QUESTIONS.

Keywords: Diabetes; GI; Incidence; Type 2; UTI.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / microbiology
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / microbiology
  • Electronic Health Records
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Humans
  • Incidence
  • Male
  • Managed Care Programs
  • Middle Aged
  • Oregon / epidemiology
  • Prevalence
  • Recurrence
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / microbiology
  • Reproductive Tract Infections / complications*
  • Reproductive Tract Infections / epidemiology
  • Reproductive Tract Infections / microbiology
  • Risk
  • Sex Factors
  • Urinary Tract Infections / complications*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology
  • Washington / epidemiology

Substances

  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human