Clinical profile and risk factors of recurrent urinary tract infection in patients with type 2 diabetes

2020 
Introduction: Type 2 diabetes (T2D) patients are at increased risk of recurrent urinary tract infection (UTI). The identification of the risk factors can help pinpoint modifiable factors amenable to a disease prevention strategy for recurrent UTI. This study is aimed to find the prevalence, clinical, biochemical profile, and risk factors of recurrent UTI in T2D patients and the effect on glycemic control and renal parameters on follow-up. Materials and Methods: This was a prospective hospital-based study done on admitted T2D UTI patients. Various clinical, biochemical parameters, and urine examination and culture were monitored. Patients were followed for 6 months concerning the number of UTIs, glycemic control, and renal parameters. Results: The prevalence of recurrent UTI was 39.6%. Recurrent UTI was common in females 61 (44.8%) compared to males 6 (18.2%). Poor renal function, uncontrolled diabetes, renal calculi, and cystopathy increase the risk of recurrent UTI in T2D females. Whereas in males, poor glycemia and lower estimated glomerular filtration rate (eGFR) increase the risk of recurrent UTI. The recurrent UTI patients had significantly higher glycosylated hemoglobin (HbA1c) at follow-up than at baseline, but renal parameters did not improve despite intensive treatment. Conclusion: Recurrent UTI is the consequences of uncontrolled glycemia, which in turn perpetuates UTI risk. A significant number of T2D patients develop recurrent UTI on follow-up, especially females. Recurrent UTI causes short and long-term hyperglycemia, and renal function continues to remain altered despite intensive treatment. The following core competencies are addressed in this article: Medical knowledge, Patient care, Practice-based learning and improvement, and Systems-based practice.
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