Type II diabetes mellitus (T2DM) is one of the most common human diseases, occurring in 10.5% of the adult population. Pathophysiological changes caused by chronic hyperglycemia increase the risk of fungal infections, including candidiasis. Candida spp. yeast often have increased virulence and therapy resistance in patients with diabetes mellitus. The study of candidiasis risk factors in patients with T2DM can help to develop effective strategies for monitoring and prevention of the infectious process development.
OBJECTIVE
To study the incidence of mucocutaneous candidiasis in patients with T2DM, identify key risk factors and assess their impact on the development of infection. Material and methods. The study included 298 patients with established diagnosis of T2DM (HbA1c>7%) aged 30—75 years. Patients were divided into 3 groups: with clinical candidiasis (n=50), subclinical candidiasis (n=112) and without candidiasis (n=136). All patients underwent physical examination, microbiological examination of smears from the skin and mucous membranes, determination of body mass index (BMI), HbA1c level in the blood, postprandial glycemia and analysis of the applied hypoglycemic therapy. Statistical processing of data is performed using dispersion (ANOVA) and correlation analysis.
RESULTS
Clinical candidiasis has been revealed in 16.78% of patients, subclinical — in 37.58%. High HbA1c (9.1±1.0%) and BMI (31.8±3.2 kg/m2) indices are associated with more pronounced colonization of the skin and mucous membranes with Candida spp. An increased risk of candidiasis development in treatment with SGLT2 inhibitors has not been detected (p=0.27). A moderate correlation relationship of the value of Candida spp. CFU with HbA1c level (r=0.558, p<0.0001) and a strong correlation with the level of postprandial glycemia (r=0.798, p<0.0001) have been established.
CONCLUSION
The study showed a high incidence of candidiasis in patients with T2DM, thus high levels of HbA1c and postprandial glycemia as well as increased BMI are key risk factors. The identified correlation relationships confirm the importance of glycemic control in the prevention of candida infection. The obtained results indicate the need to monitor skin and mucous membranes in patients with T2DM for early detection and prevention of candidiasis.
