Prevalence and recurrence of urinary tract and genital infections among adults with and without type 2 diabetes mellitus in the general population: a longitudinal cohort study

Background: This study estimated the prevalence, recurrence, and predisposing factors of self-reported urinary tract infections (UTIs) and genital infections among adults with and without type 2 diabetes mellitus (T2DM). Methods: In the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) 2008 survey, respondents reported how many times in the past 12 months they had a UTI or genital infection. T2DM respondents were compared with respondents who did not have diabetes (No DM). T2DM respondents who reported 3 or more infections were classified as having recurrent infections and were compared with T2DM respondents who reported 1-2 infections (non-recurrent infections) and those without infections. Results: The prevalence rate of UTI was 184.4/1000 for T2DM and 127.8/1000 for No DM among women (p <0.001), and 50.9/1000 for T2DM and 33.9/1000 for No DM among men (p = 0.02). Odds of experiencing a UTI were 1.5 times higher among T2DM respondents than No DM respondents. For T2DM respondents with UTI, 23% reported recurrent UTIs, largely among women. Predictors of recurrent UTIs compared with no UTIs in women were overactive bladder, kidney problems, atherosclerosis, and COPD. Among men, the prevalence rate of balanitis was 41.8/1000 for T2DM and 19.2/1000 for No DM (p <0.01). Prevalence rate of vaginitis was 172.6/1000 for T2DM and 125.0/1000 for No DM (p <0.01). Odds of vaginitis were 1.9 and balanitis were 2.3 times higher among T2DM than no DM respondents. Among T2DM women with vaginitis, 30% reported recurrent vaginitis. Lower education, receiving oral anti-diabetic drugs plus insulin, and atherosclerosis predicted recurrent vaginitis compared with non-recurrent vaginitis. Conclusions: UTIs and genital infections were more prevalent with T2DM than among respondents without diabetes. Recurrent infections occur in approximately 23%-30% of adults. Select characteristics may assist in identifying those likely to have self-reported recurrent infections.