Why people with diabetes have more UTIs and how to prevent infections
- A new study shows that high blood sugar levels in people with diabetes lead to a relative deficiency of psoriasin, an important natural antibiotic that protects against urinary tract infections.
- The researchers also showed that a topically applied estrogen cream can help restore psoriasis levels in women.
- Experts offer tips on how to avoid urinary tract infections whether you have diabetes or not.
Infections, especially urinary tract infections (UTIs), are common experiences for people with diabetes. UTIs are also often
In type 1 diabetes, the pancreas stops producing insulin, which regulates blood sugar levels. In type 2, the cells become less sensitive to insulin. In both types, high levels of glucose in the blood can reduce the effectiveness of the immune system.
dr Jason Ng of the University of Pittsburgh Medical Center, not involved in the study, explained Medical news today“The higher sugar levels create a number of impaired defense mechanisms that people use to protect themselves from UTIs.”
Now a study by researchers at Sweden’s Karolinska Institutet is investigating the mechanism behind the effects of glucose.
The study finds that high glucose levels in diabetes reduce levels of one of the body’s natural antibiotics, the antimicrobial peptide psoriasin, a key barrier to infection.
urologist dr S. Adam Ramin, also not involved in the research, described the usual role of psoriasis in this MNT:
“It is known that this particular protein represents a first line of defense against certain bacterial infections. And now, based on this study, it appears that this particular protein is down-regulated — meaning it’s not made at as high a level as it is in people who don’t have diabetes — and therefore could be one of the pathways that lead to diabetic patients being more susceptible to infection.”
“We have observed that patients with diabetes have [a] higher UTI risk,” said Dr. Ng. “So this process could further elucidate why this observation exists.”
The researchers analyzed urine, bladder cells and blood serum samples from adult volunteers who were not diabetic or had prediabetes or diabetes. The study did not include people with current UTI diagnoses.
The analysis found that participants with prediabetes or diabetes had decreased levels of psoriasis.
The researchers confirmed the results in follow-up studies using mice with type 2 diabetes and human uroepithelial cell lines.
Study leader Prof. Annelie Brauner explains Karolinska Institute news that such reduced levels “weaken the protective barrier function of the cells and increase the risk of bladder infection”.
dr Ramin explained:
“Essentially, this is a protein that inhibits the binding of bacteria to epithelial cells and
endothelial cells , and if these bacteria can’t attach to the epithelial cells of the bladder, they may not grow. They are prevented from growing and therefore cannot spread in the bladder.”“When bacteria multiply, infection occurs because infection is essentially an overgrowth of bacteria in an organ like the bladder, as opposed to a situation where psoriasin inhibits the growth of the bacteria.”
Prof. Brauner also pointed out an interesting finding.
“We found that high glucose concentrations lower levels of the antimicrobial peptide psoriasin, while insulin has no effect [on psoriasin levels],” She said.
Previous research by Prof. Brauner’s group found that estrogen helps restore the protective function of bladder cells. The new study confirms that estrogen can restore psoriasis levels.
dr Ramin said the results of the current study are consistent with previous findings about postmenopausal women with low estrogen levels who are at higher risk of developing UTIs. He said there was a significant decrease in recurrences of UTIs in women after using prescription estrogen vaginal creams, and this is one way to learn that estrogen can help prevent UTIs.
dr Ramin said topical treatment is generally safe for most women.
“Topical estrogen or estrogen creams in the vagina are not absorbed systemically, so we’re not worried about causing cancer or other problems,” he said. “In fact, many women who have had gynecologic cancer in the past and have been cured are still eligible for estrogen vaginal cream.”
Prof. Brauner also noted:
“Any medical treatment must be done with caution. Estrogen given locally (into the vagina) is a common treatment in postmenopausal women and very few side effects have been observed. However, estrogen should not be administered orally due to possible side effects and because oral administration has no proven effect in treating UTIs.”
Prof. Brauner added that experts do not recommend treating men with estrogen.
dr Ng also expressed caution:
“Without further research, I would not promote the use of estrogen to reduce the risk of UTIs by promoting psoriasis levels. We have to be careful as estrogen drugs also have significant side effects.”
“Well-controlled diabetes is important to prevent infections and other complications,” said Prof. Brauner. “Obviously, keeping blood sugar levels low to normal isn’t always easy.”
dr Ng said the best way to prevent UTIs in patients with diabetes is to practice good hygiene habits and improve sugar control as much as possible.
dr Ramin shared some tips that can help people avoid UTIs:
- Stay well hydrated to reduce bacteria levels in the urine
- Avoid constipation by consuming adequate amounts of fiber, fruit, and water
“We know that patients with constipation transfer bacteria from their rectum to their bladder or from their colon to their bladder, so it’s important to avoid constipation,” said Dr. Ramin.
“Women who are sexually active should practice good hygiene, which means it’s important for them to go to the bathroom and urinate relatively quickly after sexual activity,” he added. “It’s important to maintain good vaginal health and keep that area clean.”
dr Ramin also noted that some people may benefit from ingesting or drinking pure cranberry juice because the acidity can kill bacteria and prevent bacterial growth.
“In the future we hope to find ways to locally increase psoriasis in the bladder. We hope and believe that this could have a positive impact on the prevention of infections in the bladder,” concludes Prof. Brauner.