Epidemiology of urinary tract infections in type 2 diabetes mellitus patients: An analysis based on a large sample of 456,586 German T2DM patients

Abstract Introduction This analysis was conducted to investigate urinary tract infection (UTI) incidence among Type 2 Diabetes mellitus (T2DM) patients in Germany in a real-world setting and to identify risk factors associated with UTI incidence/recurrence. Methods Our cohort study was conducted based on an anonymized dataset from a regional German sickness fund (2010–2012). A UTI event was mainly identified through observed outpatient/inpatient UTI diagnoses. We reported the number of UTI events per 1000 patient-years. Furthermore, the proportion of patients affected by ≥1 and ≥2 UTI events in the observational period was separately reported. Finally, three multivariate Cox regression analyses were conducted to identify factors that may be associated with UTI event risk or recurrent UTI event risk. Results A total of 456,586 T2DM-prevalent patients were identified (mean age 72.8years, 56.1% female, mean Charlson Comorbidity Index (CCI) of 7.3). Overall, the UTI event rate was 87.3 events per 1000 patient-years (111.8/55.8 per 1000 patient-years for women/men ( p 89years. After 730days after first observed T2DM diagnosis, the proportion of women/men still UTI-event-free was 80.9%/90.2% ( p 79years), female gender (HR=1.38–1.57), UTIs in the previous two years (HR=2.77–5.94), number of comorbidities as measured by the CCI (HR=1.32–1.52 for CCI>6) and at least one cystoscopy in the previous year (HR=2.06–5.48). Furthermore, high HbA1c values in the previous year (HR=1.29–1.4 referring to HbA1c>9.5%) and a poor kidney function (HR=1.11–1.211 referring to glomerular filtration rate (GFR) Discussion Our study confirms that UTI event risk is high in T2DM patients. Older female patients having experienced previous UTIs face an above-average UTI risk, especially if these risk factors are associated with poor glycemic control and poor kidney function.