Issue 127 Item 7 Diabetes Substantially Increases the Risk of UTI

The use of medications for diabetes is a marker for underlying disease severity. Findings from a case-control study provide more evidence that diabetes is associated with an increased risk of acute symptomatic urinary tract infection (UTI) in postmenopausal women.

Dr. Edward J. Boyko of the University of Washington in Seattle and colleagues studied 901 women 55 to 75 years of age with an acute symptomatic UTI in the preceding month (cases) and 913 without a recent UTI (controls). Within the two groups, 13.1% and 6.8%, respectively, self-reported diabetes. Health records confirmed this diagnosis in 92% of women.

The age-adjusted odds ratio for UTI in relation to self-reported diabetes was 2.2, the authors report in the October issue of Diabetes Care. The risk for UTI was highest in women taking oral hypoglycemic agents or insulin, odds ratios 2.9 and 2.6, respectively.

Diabetic women who were not taking medication for diabetes were not at increased risk for UTI and there was no significant difference in the risk for UTI in relation to duration of diabetes.

Dr. Boyko believes that the severity of diabetes is responsible for the increased UTI risk, not the medication. He also believes that the use of medications for diabetes is a marker for underlying disease severity. He couldn’t imagine a mechanism by which these different types of medications might cause higher UTI risk. Therefore he concluded that more severe diabetes is a key player in UTI pathogenesis."

Postmenopausal women with recurrent UTI should probably be checked for the presence of diabetes, the researcher added. As a complication of diabetes, UTI may be preventable with better glucose control.

Diabetes Care 2002;25:1778-1783.