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Open Access Highly Accessed Research article

Prevalence and risk factors for vaginal Candida colonization in women with type 1 and type 2 diabetes

Ella M de Leon1, Scott J Jacober2, Jack D Sobel2 and Betsy Foxman1*

Author Affiliations

1 Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA

2 Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA

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BMC Infectious Diseases 2002, 2:1  doi:10.1186/1471-2334-2-1

Published: 30 January 2002

Abstract

Background

Diabetes mellitus increases the rate of vaginal colonization and infection with Candida species

Methods

We surveyed women with diabetes receiving care at either an urban or suburban diabetes clinic to examine the relationship between vaginal Candida colonization, diabetes type and duration, and HbA1c level. 101 participants completed the self-administered questionnaire and self-collected a vaginal swab for Candida culture. Candida colonization was similar by age and race.

Results

Type 1 diabetics were three times as likely as type 2 diabetics to be colonized with any Candida species (OR = 3.4; 95% CI: 1.03, 11.41; p = 0.04); even after adjusting for abnormal HbA1c, which had an independent effect (OR = 1.4; 95% CI: 1.04, 1.76; p = 0.02). Recent antibiotic use (OR = 4.5; 95% CI: 1.18, 16.79; p = 0.03), lifetime history of chlamydia (OR = 5.8; 95% CI: 1.09, 30.54; p = 0.04), and performing oral sex during the past 2 weeks (OR = 4.9; 95% CI:0.84, 28.27; p = 0.08) were also associated with Candida carriage after adjusting for diabetic type and abnormal HbA1c. C. albicans was isolated from the majority of colonized type 1 participants (56%), while C. glabrata was the most common isolate among colonized type 2 participants (54%).

Conclusions

Improving glucose control and possibly modifying sexual behavior may reduce risk of Candida colonization, and potentially symptomatic infection, among women with diabetes.

Keywords:
Diabetes; Candida; Vaginitis