Frequency of vagınal candida colonization and relationship between metabolic parameters in children with type 1 diabetes mellitus

J Pediatr Adolesc Gynecol. 2013 Oct;26(5):257-60. doi: 10.1016/j.jpag.2013.03.016.

Abstract

Objectives: Patients with diabetes mellitus (DM) are at risk for vulvovaginal candidasis. The aim of this study was to determine the species-specific prevalence rate and risk of candidiasis in patients with type 1 DM.

Methods: Children aged between 8-16 years were included in the study. Clinical and laboratory features of diabetes and evidence of genital symptoms were recorded. Vaginal swabs were taken from patients and placed on Sabouraud's dextrose agar and incubated. Following fasting overnight for 12 hours venous blood samples were taken simultaneously for analyses of blood glucose, HbA1c, and lipid profile. A simple 1-time fluconazole treatment regimen was used to treat patients with vulvo-vaginal candidiasis.

Results: Candida species were isolated in 30 of 76 (39%) swabs of patients with type 1 DM. Subjects who had candida colonization and candidiasis were all acute. The predominant candida species isolated from patients with type 1 DM were C.albicans 50%, C. glabrata 36.6%, C.crusei 3.3%, C.spesies 6.6%, and C.dubliniensis 3.3%. 42 patients had symptoms.The prevalence of candidiasis in symptomatic patients was 59.2%. Subjects with vulvo-vaginal candidiasis had higher mean HbA1c when compared to those who had no such infection (P = .047).

Conclusions: There seems to be a significant link between hyperglycemia and vulvo-vaginal candidiasis in patients with type 1 DM. Improving glucose control may reduce the risk of candidiasis and potentially symptomatic infection among children with diabetes. Because of high rate of colonization with candida species in diabetes, patients should undergo periodic screening for genital candidiasis.

Keywords: C.albicans; Type 1 diabetes mellitus; Vaginal colonization.

MeSH terms

  • Adolescent
  • Antifungal Agents / therapeutic use
  • Blood Glucose / metabolism
  • Candida / isolation & purification*
  • Candidiasis, Vulvovaginal / blood
  • Candidiasis, Vulvovaginal / epidemiology*
  • Candidiasis, Vulvovaginal / microbiology*
  • Carrier State / blood
  • Carrier State / epidemiology*
  • Carrier State / microbiology*
  • Child
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Female
  • Fluconazole / therapeutic use
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Pain / etiology
  • Prevalence
  • Pruritus / etiology
  • Vagina / microbiology

Substances

  • Antifungal Agents
  • Blood Glucose
  • Glycated Hemoglobin A
  • Fluconazole