Background and aimsAsymptomatic bacteriuria (ASB) is more prevalent in diabetes mellitus (DM) patients than non diabetics, but its significance is not fully known. This study was done to estimate the prevalence, clinical profile, risk factors and follow up of ASB in type 2 diabetes (T2D) patients compared with matching healthy controls. MethodsProspective, case-control study involving 400 T2D patients without symptoms of urinary tract infection (UTI) and 200 age and sex matched healthy controls. Apart from clinical and biochemical parameters, samples for urine examination and culture were taken from all the subjects. ASB was defined as ≥105 colony-forming units/ml of one or two organisms in the absence of symptoms of UTI. ResultsThe prevalence of ASB was significantly higher in T2D (17.5%) as compared to controls (10%). E. coli was the most common organism. On multivariate analysis, postmenopausal state, prior history of UTI, uncontrolled diabetes and longer duration of disease were associated with increased risk of ASB. Presence of ASB was significantly associated with symptomatic UTI at the 6-month follow up without deterioration of renal parameters. ConclusionsAsymptomatic bacteriuria was more prevalent in people with diabetes than those without diabetes. The presence of ASB may be considered a risk factor for subsequent symptomatic UTI on follow up but has no adverse effect on kidney function.