Consequences of asymptomatic bacteriuria in women with diabetes mellitus

Background: Women with diabetes mellitus (DM) have asymptomatic bacteriuria (ASB) more often than women without DM. It is unknown, however, what the c onsequences of ASB are in these women. Objectives: To compare women with DM with and without ASB for the developme nt of symptomatic urinary tract infections (UTIs), renal function, and seco ndary complications of DM during an 18-month follow-up period. Methods: In this multicenter study we monitored women with DM with and with out ASB for the development of symptomatic UTIs, renal function, and second ary complications (ie, retinopathy, neuropathy, microvascular, or macrovasc ular diseases). Data on the first 18-month follow-up period are presented. Results: At least 1 uncontaminated urine culture was available from 636 wom en (258 with type 1 DM and 378 with type 2 DM). The prevalence af ASB at ba seline was 26% (21% for those with type 1 DM and 29% for those with type 2 DM). Follow-up results were available for 589 (93%) of the 636 women. Of th ese 589 women, 115 (20%) (14%) with type 1 DM and 23% with type 2 DM) devel oped a symptomatic UTI. Women with type 2 DM and ASB at baseline had an inc reased risk of developing a UTI during the 18-month follow-up (19% without ASB vs 34% with ASB, P = .006). In contrast, there was no difference in the incidence of symptomatic UTI between women with type 1 DM and ASB and thos e without ASB (12% with ASB vs 15% without ASB). However, women with type 1 DM and ASB had a tendency to have a faster decline in renal function than those without ASB (relative increase in serum creatine level 4.6% vs 1.5%. P=0.2). Conclusion: Women with type 2 DM and ASB have an increased risk of developi ng a symptomatic UTI than those without ASB.