Prevalence and incidence of urinary tract and genital infections among patients with and without type 2 diabetes

Abstract

ObjectiveEpidemiological data on genitourinary infections (GUIs) comparing patients with and without type 2 diabetes (T2DM) is scant. We aimed to estimate the incidence of urinary tract infections (UTIs), genital infections (GIs), or any GUI in total and stratified by history of GUI and sex. Research design and methodsWe identified 39,295 patients in the Kaiser Permanente Northwest health plan with T2DM and an equal number of age and sex matched patients without diabetes. The cohort was followed for up to 9years (2006–2014). We calculated incidence rates and corresponding 95% confidence intervals (CI) of any GUI, UTIs and GIs adjusting for age, sex, race, BMI, presence of chronic kidney disease, annual number of outpatient visits, and diuretic use. ResultsAdjusted incidence of any GUI was 97.2/1000person-years (p-y) (95% CI 95.5–98.8) among the T2DM cohort vs. 79.7/1000 p-y (78.3–81.2) among those without diabetes. T2DM was associated with an adjusted 25% increased risk of UTI (rate ratio 1.25, 95% CI 1.22–1.29), a 26% increased risk of GI (1.26, 1.22–1.31) and a 22% increased risk of any GUI (1.22, 1.19–1.25). Incidence rates were lower among those with no GUI history, but the relative risks were similar. Women in both groups had higher incidence rates of GUIs than men. ConclusionsT2DM was associated with increased risks of any GUI, UTIs and GIs. Incidence rates of UTIs were higher than rates of GIs, but the relative risk of GIs was essentially identical. A similar pattern was observed when stratifying by sex. Significance of the study•Limited research suggests the risk of genitourinary infections is greater among patients with diabetes compared with nondiabetic individuals.•Our findings confirm the elevated risk of genitourinary infections and further show that the risk is greater among women and persist when limiting the analysis to patients with no prior history of genitourinary infections.•Clinicians should be alert to the increased risk of genitourinary infections especially among patients with newly diagnosed diabetes and long-term exposure to hyperglycemia. Research questions•Exposure to hyperglycemia may be a more important risk factor for new cases of genitourinary infections vs. historically recurrent cases among patients with diabetes, a possibility that warrants further investigation.•More research is needed to determine whether hyperglycemia increases the risk of new genitourinary infections in a dose/time-dependent manner.•The extent to which genitourinary infections increase the risk of chronic kidney disease needs more study.