Meta-Analysis of the Significance of Asymptomatic Bacteriuria in Diabetes

Abstract

OBJECTIVETo evaluate whether asymptomatic bacteriuria (ASB) is more common in patients with diabetes than among control subjects. In addition, we wanted to clarify the clinical significance of ASB in patients with diabetes.RESEARCH DESIGN AND METHODSWe conducted a systematic review and meta-analysis of published data since 1966. Twenty-two studies fulfilled the inclusion criteria of the meta-analysis.RESULTSASB was present in 439 of 3,579 (12.2%) patients with diabetes and in 121 of 2,702 (4.5%) healthy control subjects. ASB was more common both in patients with type 1 diabetes (odds ratio 3.0 [95% CI 1.1–8.0]) and type 2 diabetes (3.2 [2.0–5.2]) than in control subjects. The point prevalence of ASB was higher in both women (14.2 vs. 5.1%; 2.6 [1.6–4.1]) and men (2.3 vs. 0.8%; 3.7 [1.3–10.2]) as well as in children and adolescents (12.9 vs. 2.7%; 5.4 [2.7–11.0]) with diabetes than in healthy control subjects. Albuminuria was more common in patients with diabetes and ASB than those without ASB (2.9 [1.7–4.8]). History of urinary tract infections was associated with ASB (1.6 [1.1–2.3]).CONCLUSIONSWe were able to show that the prevalence of ASB is higher in all patients with diabetes compared with control subjects. We also found that diabetic subjects with ASB more often had albuminuria and symptomatic urinary tract infections.

Systematic review of complications and outcomes of diabetic patients with burn trauma

“…This is consistent with the literature regarding UTI in diabetic patients in general. Within the general population, diabetic patients have a 1.5-4 times increased incidence of bacteriuria compared to non-diabetic patients [29]. For instance, a study done by Hirji et al [30] noted that the incidence of UTI was 46.9 per 1000 person-years among diabetic patients and 29.6 for non-diabetic patients.…”

Albuminuria Is Not Associated with Bacteriuria in Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Observational Studies

“…In a previous meta-analysis, Renko et al [1] reported an increased prevalence of albuminuria in diabetic patients with asymptomatic bacteriuria as compared to those without (OR: 2.9, 95% CI: 1.7–4.8). Only three observational studies (871 participants) were included in their analysis, all of which evaluated women [4,11,12].…”

“…Bacteriuria is present in 12.2% of patients with diabetes [1], reaching a prevalence rate of 30% in diabetic women [2]. It has been recommended that urinary albumin be measured in sterile urine for the proper diagnosis of diabetic nephropathy [3].…”

Urinary Tract Infection in Diabetes

“…우선 소변 내의 높은 포도당 농도가 세균의 성장을 촉진시킬 수 있을 것이다 [5,17]. 하지만 여러 연구에서 당화혈색소 수치와 요로 감염 사이의 관련성은 발 견되지 않았고 [18,19], 기전상 소변 내 포도당 농도를 높이 는 sodium-glucose co-transporter 2 (SGLT2) 억제제 또 한 요로 감염의 위험을 높이지 않아 추가 연구가 필요하다 [20]. 하지만 신장 실질 내 포도당 농도가 높은 것은 세균의 성장, 증식에 유리하고 이로 인해 신우신염 및 신장 합병증 의 위험을 높인다 [21].…”