Leukocyturia in women with diabetes and its clinical implications

Background. Urinalysis is one of the most common studies performed on the d iabetic patient at every visit. The presence of leukocyturia is relatively common but it is not clear what the attitude of the physician toward this p articular finding should be. The main objective of the present study was to investigate the clinical significance of leukocyturia in diabetic women. Methods. Ninety-eight diabetic women (84.7% type 2) aged 57 +/- 13 years wh o were being seen at the diabetic out-patient clinic were randomly selected . All patients underwent a clinical and gynecologic examination and a urina lysis. A Papanicolaou smear and a urine culture were also obtained. Results. The overall prevalence of leukocyturia (>5 cells/high power field (hpl)) was 46.5%. Patients with urinary tract infections (UTI) were 7.5 tim es more likely to have leukocyturia, while a leukocyte count <5cells/hpf pr edicted the absence of UTI in 96% of the women. In the comparison of patien ts with and without leukocyturia, we found that proteinuria (p = 0.06) and bacteriuria (p <0.092) were more common in the women with leukocyturia. A s ignificant association with leukorrhea was not demonstrated. The empirical use of antibiotics was 12 times more frequent in the patients with leukocyt uria. Conclusions. A urinary culture should be requested in all diabetic patients with leukocyturia. The possibility of a Un is remote when leukocyturia is absent. (C) 2000 IMSS. Published by Elsevier Science Inc.