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Switch to insulin therapy does not reduce rate of UTIs in Type 2 diabetics
11 March 2010
MedWire News: There is no evidence that switching from oral treatment to insulin therapy reduces the high rate of urinary tract infections (UTIs) in patients with Type 2 diabetes, say researchers.
Type 2 diabetics have an increased risk for UTIs, particularly adult women who have a self-reported rate of about 10%.
“The biological mechanisms of increased UTI risk among diabetic patients remain uncertain, but are likely to include immune mechanisms responsive to the quality of glycemic control,” say Reimar Thomsen (Aarhus University Hospital, Aalborg, Denmark) and colleagues.
It has been suggested that insulin treatment may have a protective effect against UTIs, as it is thought to have anti-inflammatory properties and protect against infection. Thomsen and team therefore investigated the risk for antibiotic-treated UTIs in 2737 Type 2 diabetics before and after they switched from oral antidiabetic agents to insulin treatment.
The researchers observed each patient for 365 days before and after switching treatment, excluding a 120-day window around the switch date. UTI infections were defined as filled prescriptions for UTI-specific antibiotics.
Following the switch to insulin, 53% of patients had a significant decrease in glycated hemoglobin (median=1.5%). In the period before switching 437 (16.0%) patients had UTIs and after switching 446 (16.3%) patients had UTIs, demonstrating no significant difference in rates following change in treatment for diabetes.
“This population-based study showed a high annual risk of treated UTIs in Type 2 diabetic patients with no substantial effect of improved glycemic control and/or initiation of insulin therapy,” conclude Thomsen et al in the Journal of Diabetes and Its Complications.
They say: “The increased risk for UTI in diabetics is apparently not reduced by tightened glycemic control.
“However, this treatment goal should be retained to reduce classic complications of diabetes.”
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