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Diabetes and Urinary Tract Infections (UTIs) Link you Need to Know

by Dr. Jayashree Gopinath on Sep 20 2022 11:24 PM
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Does diabetes cause urinary tract infections? The suppressed immune system compromises the urinary bladder’s cell barrier, increasing the risk of urinary tract infections.

Diabetes and Urinary Tract Infections (UTIs) Link you Need to Know
The immune system of people with diabetes has lower levels of the antimicrobial peptide psoriasin, which compromises the urinary bladder’s cell barrier, increasing the risk of urinary tract infection, according to a new study published in Nature Communications.
Diabetes results from a lack of insulin and/or decreased insulin action. Insulin is a hormone that regulates glucose (sugar) and thus energy to the cells. In type 1 diabetes, the body stops producing insulin, while in type 2 diabetes, the cells have become less sensitive to insulin, which contributes to high blood glucose levels.

Diabetes is a common disease that affects health in many ways. Lower immunity and recurring infections are common in type 1 and type 2 diabetes.

How Blood Glucose Level Affects Urinary System?

Researchers at Karolinska Institutet investigated whether glucose levels in people with diabetes (type 1, type 2, or pre-diabetes) are linked with psoriasin, an endogenous antibiotic that is a part of the innate immune system.

Using urine, urinary bladder cells, and blood serum samples from patients, the researchers analyzed levels of psoriasin and other peptides necessary for ensuring that the bladder mucosa remains intact and protects against infection. The findings were then verified in mice and urinary bladder cells with and without infection.

They found that high glucose concentrations reduce the levels of the antimicrobial peptide psoriasin, while insulin has no effect. People with diabetes have lower levels of psoriasin, which weakens the cells’ protective barrier function and increases the risk of bladder infection.

Is Estrogen Therapy a Solution for Urinary Tract Infections?

Previous studies have shown that treatment with estrogen restores the protective function of bladder cells in humans and mice and thereby helps to regulate the immune response to a UTI.

Researchers, therefore, tested how estrogen treatment affects infected cells exposed to high glucose concentrations. They found that the treatment boosted levels of psoriasin and reduced bacterial populations, indicating that the treatment may have an effect also among patients with diabetes.

Researchers are now planning to probe deeper into the underlying mechanisms of infections in individuals with diabetes. The ultimate goal is to reduce the risk of infection in this growing patient group.

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