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Urinary System And Diabetes

Urinary Tract Infections In Patients With Type 2 Diabetes Mellitus: Review Of Prevalence, Diagnosis, And Management

Urinary Tract Infections In Patients With Type 2 Diabetes Mellitus: Review Of Prevalence, Diagnosis, And Management

Go to: Introduction Type 2 diabetes mellitus is a heterogeneous group of disorders characterized by variable degrees of insulin resistance, impaired insulin secretion, and increased glucose production. Patients with type 2 diabetes mellitus are at increased risk of infections, with the urinary tract being the most frequent infection site.1–4 Various impairments in the immune system,5,6 in addition to poor metabolic control of diabetes,7,8 and incomplete bladder emptying due to autonomic neuropathy9,10 may all contribute in the pathogenesis of urinary tract infections (UTI) in diabetic patients. Factors that were found to enhance the risk for UTI in diabetics include age, metabolic control, and long term complications, primarily diabetic nephropathy and cystopathy.11 The spectrum of UTI in these patients ranges from asymptomatic bacteriuria (ASB) to lower UTI (cystitis), pyelonephritis, and severe urosepsis. Serious complications of UTI, such as emphysematous cystitis and pyelonephritis, renal abscesses and renal papillary necrosis, are all encountered more frequently in type 2 diabetes than in the general population.12,13 Type 2 diabetes is not only a risk factor for community-acquired UTI but also for health care-associated UTI,14 catheter-associated UTI,15 and post-renal transplant-recurrent UTI.16 In addition, these patients are more prone to have resistant pathogens as the cause of their UTI, including extended-spectrum β-lactamase-positive Enterobacteriaceae,17 fluoroquinolone-resistant uropathogens,18 carbapenem-resistant Enterobacteriaceae,19 and vancomycin-resistant Enterococci.20 Type 2 diabetes is also a risk factor for fungal UTI, mostly caused by Candida.21 Diabetes is also associated with worse outcomes of UTI, including longer hospitalizations and incre Continue reading >>

Diabetes & Sexual & Urologic Problems

Diabetes & Sexual & Urologic Problems

Troublesome bladder symptoms and changes in sexual function are common health problems as people age. Having diabetes can mean early onset and increased severity of these problems. Sexual and urologic complications of diabetes occur because of the damage diabetes can cause to blood vessels and nerves. Men may have difficulty with erections or ejaculation. Women may have problems with sexual response and vaginal lubrication. Urinary tract infections and bladder problems occur more often in people with diabetes. People who keep their diabetes under control can lower their risk of the early onset of these sexual and urologic problems. Diabetes and Sexual Problems Both men and women with diabetes can develop sexual problems because of damage to nerves and small blood vessels. When a person wants to lift an arm or take a step, the brain sends nerve signals to the appropriate muscles. Nerve signals also control internal organs like the heart and bladder, but people do not have the same kind of conscious control over them as they do over their arms and legs. The nerves that control internal organs are called autonomic nerves, which signal the body to digest food and circulate blood without a person having to think about it. The body's response to sexual stimuli is also involuntary, governed by autonomic nerve signals that increase blood flow to the genitals and cause smooth muscle tissue to relax. Damage to these autonomic nerves can hinder normal function. Reduced blood flow resulting from damage to blood vessels can also contribute to sexual dysfunction. What sexual problems can occur in men with diabetes? Erectile Dysfunction Erectile dysfunction is a consistent inability to have an erection firm enough for sexual intercourse. The condition includes the total inability to h Continue reading >>

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes - A Major Risk Factor For Kidney Disease

Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body. The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life. Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans. With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood. Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that h Continue reading >>

Diabetes And The Risk Of Acute Urinary Tract Infection Among Postmenopausal Women

Diabetes And The Risk Of Acute Urinary Tract Infection Among Postmenopausal Women

OBJECTIVE—To examine whether the presence of diabetes alters the risk of acute urinary tract infection (UTI) in postmenopausal women. RESEARCH DESIGN AND METHODS—A case-control study of the Group Health Cooperative of Puget Sound (GHC), a staff-model nonprofit health maintenance organization in Washington State, was conducted. Subjects were women aged 55–75 years who had been members of GHC for at least 1 year and who had had an acute symptomatic UTI within the preceding month. Laboratory files were used to identify women with a urine culture that grew ≥105 colonies of a urinary pathogen. Medical records were reviewed to confirm the presence of acute, clinically symptomatic UTI. Control subjects were randomly selected from the GHC enrollment file, screened to remove women with recent UTI, and frequency matched to cases by age within 2 years. An interviewer ascertained self-reported clinician-diagnosed diabetes. Diagnosis of diabetes was confirmed by the GHC diabetes registry. A subsample of women underwent measurement of postvoid residual bladder volume (n = 748) and culture of vaginal flora (n = 454). RESULTS—Of the 901 case and 913 control subjects, diabetes was reported in 13.1 and 6.8%, respectively. The health plan diabetes registry confirmed the diagnosis in 92% of women who self-reported the condition. The age-adjusted odds ratio (OR) for UTI in relation to self-reported clinician-diagnosed diabetes was 2.2 (95% CI 1.6–3.0). Adjustment for frequency of sexual intercourse and history of UTI had little effect on this estimate. Compared with nondiabetic women, higher UTI odds were seen in subjects who used oral hypoglycemic agents (OR 2.9 [95% CI 1.7–5.1]) and insulin (2.6 [1.5–4.6]) but not in subjects with untreated diabetes or diabetes treated by Continue reading >>

Urinary Tract Infection In Diabetes

Urinary Tract Infection In Diabetes

Nicolle, Lindsay E Purpose of review The aim of this article is to review recent publications relevant to understanding the interaction of urinary tract infection and diabetes mellitus, including epidemiology, pathogenesis, microbiology, and treatment. Recent findings The largest number of identified reports described aspects of epidemiology, including defining the incidence and outcomes of urinary infection in patients with diabetes. In several reports, mortality and risk of hospitalization for urinary infection were not increased with diabetes, although length of hospitalization may be prolonged. Other reports quantify the increased incidence of cystitis or pyelonephritis in persons with diabetes, but remain subject to potential biases which could overestimate the occurrence in diabetic relative to non-diabetic populations. Several reports suggest that resistant bacteria are more frequently isolated from diabetic outpatients with urinary infection, but it is not clear how this is directly attributable to diabetes. There are no recent clinical trials which enhance our understanding of optimal treatment of symptomatic urinary infection, although several review articles acknowledge the appropriateness of the non-treatment of asymptomatic bacteriuria in diabetic women. Summary Recent reports exploring diabetes and urinary tract infection provide some insights, particularly for risks of infection and outcomes, but there are no recent large advances in the knowledge base. Questions related to incidence, optimal treatment, and role of metabolic control still need to be addressed to expand the knowledge base and enhance management of this common problem. Abbreviation ESBL: extended spectrum beta lactamase. © 2005 Lippincott Williams & Wilkins, Inc. Continue reading >>

Urinary Tract Infection

Urinary Tract Infection

Diabetics are particularly prone to urinary tract infections (UTIs) because hyperglycemia [1] causes sugar to spill into the urine, and that sugary urine, while still in the body, becomes friendly to bacterial cultures [2]. Since another symptom of hyperglycemia is excess urination, all the tissues of the urinary tract are being frequently bathed with this sugary bacterial culture. [3][4] Illness places the body under stress, which can raise blood glucose levels. It also goes to work trying to rid itself of the problem; this causes some hormonal release of some of the same counter-regulatory hormones the body releases when it feels it's being threatened with hypoglycemia. [5] This can make it difficult to keep in good control using the same amount of insulin when there's no illness. Humans with diabetes have "sick day" plans; on those days, more insulin, more blood glucose testing and checking for ketones may be needed. In addition, a UTI can be a complication to diabetes since infections tend to cause hyperglycemia; hypoglycemia is also possible when dealing with infections. [8][9] The bacteria can migrate from the bladder to the kidneys causing kidney infection if bladder infections are left untreated. [10][11] The best prevention for this vicious circle is regulating blood glucose as best you can and treating the UTI when it becomes apparent. This is usually done with antibiotics.[12] Recurring UTIs can often be a sign of poor regulation. UTI's can often be hidden [13] (called occult infections) [14], with no clinical signs and normal-looking urinalysis results. [15][12] Urine culture [16][17] may help detect these hidden infections. [18]. Some dogs have chronic urinary tract infections with no evidence of it in their blood glucose levels [19] Long-term steroid use c Continue reading >>

Urinary Tract Infection

Urinary Tract Infection

Diabetics are particularly prone to urinary tract infections (UTIs) because hyperglycemia[1] causes sugar to spill into the urine, and that sugary urine, while still in the body, becomes friendly to bacterial cultures. Since another symptom of hyperglycemia is excess urination, all the tissues of the urinary tract are being frequently bathed with this sugary bacterial culture[2]. In addition, a UTI can be a complication to diabetes since infections tend to cause hyperglycemia; hypoglycemia is also possible when dealing with infections[4][5]. The bacteria can migrate from the bladder to the kidneys causing Kidney infection if bladder infections are left untreated[6] The best prevention for this vicious circle is regulating blood glucose as best you can and treating the UTI when it becomes apparent. This is usually done with antibiotics. Recurring UTIs in diabetic cats can often be a sign of poor regulation[7]. UTI's can often be hidden[8] (called occult infections), with no clinical signs and normal-looking urinalysis results. Urine culture may help detect these hidden infections[9]. Some dogs have chronic urinary tract infections with no evidence of it in their blood glucose levels[10]. Recurring urinary tract infections may be the first 'alert' regarding an underlying disease or condition. The 2003 study link below of 100 dogs who had various recurrent urinary tract infections found that 71 of them had other diseases or conditions which would make them more prone to having UTIs. Those who had their predisposing disorder(s) AND their urinary infections treated were much less likely to suffer recurrences of their urinary problems than those whose UTIs alone were treated[11][12]. Need discussion of symptoms, treatment, and the effect of a UTI diet on a diabetic diet. Find Continue reading >>

Kidneys (nephropathy)

Kidneys (nephropathy)

Kidney disease can happen to anyone but it is much more common in people with diabetes and people with high blood pressure. Kidney disease in diabetes develops very slowly, over many years. It is most common in people who have had the condition for over 20 years. About one in three people with diabetes might go on to develop kidney disease, although, as treatments improve, fewer people are affected. What is kidney disease? The kidneys regulate the amount of fluid and various salts in the body, helping to control blood pressure. They also release several hormones. Kidney disease (or nephropathy to give it its proper name) is when the kidneys start to fail. If the kidneys start to fail they cannot carry out their jobs so well. In the very early stages there are usually no symptoms and you may not feel unwell, this can mean there are changes in blood pressure and in the fluid balance of the body. This can lead to swelling, especially in the feet and ankles. As kidney disease progresses, the kidneys become less and less efficient and the person can become very ill. This happens as a result of the build up of waste products in the blood, which the body cannot get rid of. Kidney disease can be a very serious condition. Why are people with diabetes more at risk? Kidney disease is caused by damage to small blood vessels. This damage can cause the vessels to become leaky or, in some cases, to stop working, making the kidneys work less efficiently. Keeping blood glucose levels as near normal as possible can greatly reduce the risk of kidney disease developing as well as other diabetes complications. It is also very important to keep blood pressure controlled. How does my doctor check for kidney disease? As part of your annual health care review you should have a blood and urine t Continue reading >>

Bladder & Kidneys

Bladder & Kidneys

Kidney and bladder damage is a complication of diabetes. People with diabetes are at risk of bladder and kidney infections, kidney failure and dialysis Maintaining good blood glucose control and keeping your blood pressure at a healthy level will reduce this risk Annual kidney health checks are recommended Kidney Disease Kidney disease occurs when the nephrons inside your kidneys, which act as blood filters, are damaged. This leads to the build up of waste and fluids inside the body. If kidney disease is not diagnosed, it can lead to serious complications including kidney failure, which requires dialysis or a kidney transplant to keep you alive. Kidney disease and diabetes Each kidney contains up to one million nephrons, the filtering units of the kidneys. Inside a nephron is a tiny set of looping blood vessels called the glomerulus. Diabetes can damage the kidney filters, leading to diabetic kidney disease, or diabetic nephropathy. If kidney disease is found early, medication, dietary and lifestyle changes can increase the life of your kidneys and keep you feeling your best for as long as possible. Symptoms In some cases diabetic kidney disease causes the kidney filters to become blocked and stop working, which results in kidney failure. Symptoms of kidney failure may be general and can include: changes in the amount and number of times urine is passed blood in the urine tiredness loss of appetite difficulty sleeping headaches lack of concentration shortness of breath nausea and vomiting Controlling blood sugar levels can slow down the development of diabetic kidney disease. Kidney health check It is very important that diabetic kidney disease is detected early as treatment can help to increase the life of the kidneys. Your health care team can give you practical advic Continue reading >>

Prevalence Of Urinary Tract Infection And Antimicrobial Susceptibility Among Diabetic Patients With Controlled And Uncontrolled Glycemia In Kuwait

Prevalence Of Urinary Tract Infection And Antimicrobial Susceptibility Among Diabetic Patients With Controlled And Uncontrolled Glycemia In Kuwait

Journal of Diabetes Research Volume 2016 (2016), Article ID 6573215, 7 pages 1Clinical Services Department, Dasman Diabetes Institute, P.O. Box 1180, 15462 Kuwait, Kuwait 2Biochemistry & Molecular Biology Unit, Dasman Diabetes Institute, P.O. Box 1180, 15462 Kuwait, Kuwait Academic Editor: Giovanni Annuzzi Copyright © 2016 May Sewify et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Diabetic patients have higher risk of urinary tract infection (UTI). In the present study, we investigated the impact of glycemic control in diabetic patients on UTI prevalence, type of strains, and their antimicrobial drugs susceptibility. This study was conducted on urine samples from 722 adult diabetic patients from which 252 (35%) samples were positive for uropathogens. Most UTI cases occurred in the uncontrolled glycemic group (197 patients) versus 55 patients with controlled glycemia. Higher glycemic levels were measured in uncontrolled glycemia group (HbA1c = 8.3 ± 1.5 and 5.4 ± 0.4, resp., ). Females showed much higher prevalence of UTI than males in both glycemic groups (88.5% and 11.5%, resp., ). In the uncontrolled glycemia group 90.9% of the UTI cases happened at ages above 40 years and a clear correlation was obtained between patient age ranges and number of UTI cases (; ), whereas in the group with controlled glycemia no trend was observed. Escherichia coli was the predominant uropathogen followed by Klebsiella pneumoniae and they were together involved in 76.2% of UTI cases. Those species were similarly present in both diabetic groups and displayed comparable antibiotic resistance pattern. The Continue reading >>

Diabetes And Urinary Tract Infections: What You Need To Know

Diabetes And Urinary Tract Infections: What You Need To Know

The urgent need to go. The burning pain when you do. The cloudy, foul-smelling urine. If you've experienced a urinary tract or bladder infection, you'd probably prefer to avoid another one. Unfortunately, if you have diabetes, you are up to twice as likely as those without the disease to develop these often painful infections. They’re especially common among women. But there’s a lot you can do to avoid them and to ease your discomfort when they do strike. Making healthy lifestyle choices is key to managing type 2 diabetes, but it can be hard to stay on track. Dr. Anthony Cardillo explains that focusing on diet, exercise and stress reduction can help you maintain control of your diabetes. 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. Why Diabetes Poses a Risk Urinary tract infections, or UTIs, occur when bacteria or other bugs invade your body’s drainage system. Normally, your immune defenses banish these bugs before they can grow and multiply. But if you have diabetes, the following factors interfere: Diabetes impairs some parts of your immune response. You have fewer white blood cells and T cells to fight off invading bacteria, viruses, and fungi. For the same reason, diabetics often develop UTIs caused by less commonly encountered germs. Routine antibiotics may be ineffective. Nerve damage can keep your bladder from emptying, either by weakening muscles or scrambling the signals between your brain and urinary system. Urine that remains in your body too long poses a greater infection risk. Sugar in your blood and urine can also contribute to a greater risk for UTI. Besides pain and Continue reading >>

Diabetes And Its Impact On Your Urinary And Sexual Health

Diabetes And Its Impact On Your Urinary And Sexual Health

Diabetes and urological health issues are closely connected. Diabetics are prone to urinary tract infections (UTIs), bladder issues and sexual dysfunction. Diabetes can often make your urologic conditions even worse because it can impact blood flow, nerves and sensory function in the body. Roughly 29.1 million people or 9.3 % of Americans have diabetes. Diabetes is a disease in which your blood glucose (blood sugar) levels are too high. Glucose is the body's main source of fuel and comes from the foods you eat. After your body breaks down food, glucose enters the bloodstream. The cells in your body need this sugar for energy, but a hormone called insulin must be present for the glucose to enter the cells. Your pancreas, a large gland that sits behind the stomach, is what makes the insulin. In people without diabetes, the pancreas makes the right amount of insulin to move the sugar from the blood into the cells. But, in people with type 1 diabetes, the body doesn't make insulin at all. In people with type 2 diabetes, the body doesn't make or use insulin the right way. This is called insulin resistance. Without enough insulin, glucose stays in the blood. Having too much of this in the bloodstream can harm your kidneys, eyes and other organs. The A1C test is used by doctors to see how well you're taking care of your diabetes. This blood test gives facts about a person's blood sugar levels over the past two to three months. The American Diabetes Association suggests an A1C of 7 percent or below. Bladder Conditions and Urinary Tract Infections "Diabetes can affect the function and structure of the lower urinary tract, which in turn may play a role in patients with diabetes having more UTIs, overactive or underactive bladder, and problems with urination," says Michael J. Kenn Continue reading >>

What You Need To Know About Utis

What You Need To Know About Utis

Burning when you urinate. A frequent urge to urinate. Pain in your back or abdomen. Do any of these symptoms sound familiar? These are all symptoms of a urinary tract infection, or UTI, for short. Studies show that people with Type 2 diabetes have a greater risk of getting a UTI than people without diabetes. Despite the fact that UTIs are all too common and downright annoying, they can also lead to more serious situations if they’re not caught and treated. What is a UTI, anyway? A UTI is an infection in your urinary tract. Your urinary tract includes your kidneys, bladder, ureters, urethra, and, in men, prostate. Most UTIs occur in your bladder, the organ that stores your urine. What causes a UTI? A UTI is caused by bacteria, usually from the bowels. Normally, the urinary tract system has safeguards to protect against infection. For example, the ureters, which are the tubes that carry urine from the kidneys to the bladder, have one-way valves to prevent urine from backing up into the kidneys. The process of emptying your bladder (called urination) also helps to flush out bacteria and other microbes. And a healthy immune system helps protect against infection, as well. Why are UTIs more common in people with diabetes? UTIs are the second most common type of infection. Women are 10 times more likely to get a UTI than men because of their anatomy. In fact, more than 50% of women will have a UTI at some point in their lives. If you’re a woman with Type 2 diabetes, your risk may be even higher, according to two recent studies. In one study, 9% of the subjects with diabetes had UTIs compared with 6% of those without diabetes. And the second study showed that people with diabetes had a 60% higher risk of getting a UTI compared to those without diabetes. Why are people with Continue reading >>

Genital And Urinary Tract Infections In Diabetes: Impact Of Pharmacologically-induced Glucosuria

Genital And Urinary Tract Infections In Diabetes: Impact Of Pharmacologically-induced Glucosuria

1. Introduction Type 2 diabetes mellitus (T2DM) is a debilitating disease with multiple complications resulting from hyperglycaemia, inflammation, and possibly immune dysfunction. In addition to macro- and micro-vascular damage, T2DM is also associated with increased risks of asymptomatic bacteriuria (ASB), urinary tract infections (UTIs), and non-sexually transmitted genital infections (vulvovaginal infections and balanitis) [1,2]. ASB is defined as two consecutive voided urine specimens with isolation of the same bacterial strain in quantitative counts ≥105 colony-forming units per millilitre collected from a patient without symptoms of a UTI [3]. The presence of ASB (most commonly caused by Escherichia coli [E. coli] and Klebsiella pneumoniae [K. pneumoniae]) is a major risk factor for developing symptomatic UTI [4]. Patients with diabetes generally present with symptoms of UTIs similar to those reported in healthy controls. Complications of UTIs are also more common in patients with diabetes [5], and this population has an increased risk of acute upper UTI (pyelonephritis) requiring hospital admission [6]. Emphysematous pyelonephritis, a severe manifestation of this disease, is seen almost exclusively in patients with diabetes. This review article aims to explore the relationship between diabetes and UTIs and genital infections, particularly in the context of emerging new therapies for T2DM that pharmacologically increase urinary glucose concentrations. 2. Search strategy We conducted a search of the scientific literature to identify relevant studies in MEDLINE (1990–2012) using the search terms–type 2 diabetes, infections, urinary, vaginitis, balanitis and bacteriuria. We limited the literature searches to humans and English-language publications. The searche Continue reading >>

Urologic Complications Of Diabetes

Urologic Complications Of Diabetes

BLADDER DYSFUNCTION Over 50% of men and women with diabetes have bladder dysfunction (4,5). Current understanding of bladder dysfunction reflects a progressive condition encompassing a broad spectrum of lower urinary tract symptoms including urinary urgency, frequency, nocturia, and incontinence. Previously, the dysfunction has been classically described as diminished bladder sensation, poor contractility, and increased postvoid residual urine, termed bladder cystopathy (6). However, bladder cystopathy most likely represents end-stage bladder failure with symptoms of infrequent voiding, difficulty initiating voiding, and postvoid fullness and is relatively uncommon. A number of clinical studies in men and women with diabetes have reported bladder instability or hypersensitivity as the most frequent finding, ranging from 39–61% of subjects (5,7). Diminished bladder contractility or sensation has been found less often (5), and an acontractile bladder appears to be quite uncommon. Bladder dysfunction in women In women, urinary incontinence is estimated to affect nearly 50% of middle aged and older women, leading to significant distress, limitations in daily functioning, and poorer quality of life (8,9). Diabetes has been identified as an important independent risk factor for incontinence in several large observational studies, including the Nurses’ Health Study, and is associated with 30–100% increased risk (9–12). This suggests that interventions that prevent or delay onset of diabetes may also prevent urinary incontinence. The Diabetes Prevention Program (DPP) randomized trial demonstrated that an intensive lifestyle intervention involving weight loss and exercise reduced the incidence of diabetes among women with impaired glucose tolerance (IGT) (13). Prevalence Continue reading >>

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