Diabetes is a chronic disease that causes high levels of blood glucose. This is a result of the pancreas producing insufficient insulin to regulate blood glucose levels. The excess sugar in the blood can lead to health complications, including heart disease, kidney failure, and amputation of the lower extremities.
People with diabetes are more prone to infection. This risk increases with time, meaning that individuals who have had diabetes for a long time have a higher risk of infection. The common understanding is that reduced blood flow to the extremities and high sugar levels allow bacteria to grow and result in infections.
Individuals with diabetes commonly experience infections in the ears, nose, or throat, skin and soft tissue infections, and urinary tract infections. Researchers at the Karolinska Institutet in Sweden are now shedding more light on the link between diabetes and urinary tract infections.
The researchers studied the impact of high glucose on antimicrobial peptides. Antimicrobial peptides are part of the first line of innate immune response. These peptides defend epithelial cells in the urinary tract from pathogens. The researchers found that high glucose in antimicrobial peptides resulted in significantly lower expression of genes S100A7, DEFB4A, and RNASE7.
Annelie Brauner, a professor at the Department of Microbiology at the Karolinska Institutet who led the study, says that the group’s research shows that “people with diabetes have lower levels of psoriasin, which weakens the cells’ protective barrier function and increases the risk of bladder infection.”
Researchers at the Karolinska Institutet plan to continue their research on the underlying mechanisms of infections in individuals with diabetes in the hopes of developing therapies to lower this risk.
One future area of research is the use of oestrogen treatment to boost levels of antimicrobial peptides. Past research by this group has shown promising results in reducing bacterial populations with this type of treatment. “The ultimate goal is to reduce the risk of infection in this growing patient group,” says Brauner.