Candida species oral detection and infection in patients with diabetes mellitus: a meta-analysis

Abstract

Introduction: Diabetes mellitus is a chronic metabolic disorder that induces elevated plasma glucose levels. Diabetic patients are more susceptible to infections, especially fungal infections. There is a direct relationship between increased blood glucose levels and the number of Candida hyphae in the oral mucosa. This study aimed to evaluate oral candidiasis and the different Candida species found in patients with and without diabetes mellitus. Methods: A search for studies on oral candidiasis and diabetes mellitus was carried out in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS) and Google Scholar. For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratios (OR) using the Mantel-Haenszel (M-H) method with 95% confidence intervals. Results: 25 studies were included in this meta-analysis. Diabetes Mellitus patients tripled the probability of being infected by Candida species (OR:3.16, p<0.001). Likewise, Candida species infections were more likely in patients with poor glycemic control (OR:2.94, p<0.001) and with dentures (OR:2.22, p<0.001). In contrast, neither gender nor diabetes mellitus type of diabetes conditioned fungal infections (p>0.05). The most prevalent Candida species in both diabetics and controls were C. albicans and C. tropicalis. Diabetics had significantly fewer C. non-albicans species oral infections than non-diabetics (p=0.04). Conclusions: Diabetics are more prone to oral candidiasis, especially C. albicans infections.

Distribution of demographic characteristics and predisposing disease in oral candidiasis patients at Prof. Ngoerah Hospital Denpasar in 2022-2023

“…The occurrence of oral candidiasis in patients with diabetes is associated with poor glycemic control, high glucose content in saliva, xerostomia, and changes in saliva pH. Based on previous research, patients with diabetes had 3.16 times more Candida species as microflora in their oral cavity [24]. Increasing the amount of Candida in the oral cavity causes an increased risk of opportunistic oral candidiasis infections [25,26].…”

Candida albicans skin infection in diabetic patients: An updated review of pathogenesis and management

“…222,223 Studies have indicated a higher prevalence of Candida species infections, particularly C. albicans, in diabetic patients. [224][225][226] Petrova et al have found a higher prevalence of genital candidiasis in girls with T1DM, 227 and other studies found a significant increase in oral candidal carriage in patients with T2DM. 221,228 NCAC species, including C. tropicalis and N. glabrata, have been identified in these infections.…”

“…However, more NCAC species are emerging as successful pathogens and causing candidiasis 222,223 . Studies have indicated a higher prevalence of Candida species infections, particularly C. albicans , in diabetic patients 224–226 . Petrova et al.…”