BACTERIOLOGICAL PROFILES AND ANTIBIOTIC RESISTANCE PATTERNS IN URINARY TRACT INFECTIONS AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS AND NEPHROPATHY

Diabetes is among the most prevalent chronic conditions, impacting individuals of all ages around the globe. According to the latest data for 2021 released by the International Diabetes Federation, there were approximately 537 million cases of diabetes worldwide; Official health system registers report over 245,000 people living with diagnosed diabetes in Uzbekistan (all types). Additionally, screening-based studies, about 5.4 % of the Uzbek adult population is estimated to have diabetes (mainly type 2), though actual prevalence may be higher. And also Urinary tract infections (UTIs) are more prevalent, severe, and associated with poorer outcomes in individuals with type 2 diabetes mellitus. These infections are frequently caused by antibiotic-resistant pathogens. Factors such as immune system impairments, inadequate metabolic control, and incomplete bladder emptying due to autonomic neuropathy may all contribute to the heightened risk of UTIs in this population. Notably, the newer class of anti-diabetic medications known as sodium-glucose cotransporter 2 (SGLT2) inhibitors has not been shown to significantly raise the incidence of symptomatic urinary tract infections. The symptoms of UTIs in diabetic patients resemble those in non-diabetic individuals, although some patients with diabetic neuropathy may present with atypical clinical signs. Treatment approaches depend on various factors, including the presence and severity of symptoms, whether the infection is confined to the bladder or also affects the kidneys, any urological abnormalities, metabolic changes, and renal function. It is important to note that asymptomatic bacteriuria in diabetic patients does not require treatment. Diabetic nephropathy (DN) is a microvascular complication of diabetes that affects the kidneys, leading to: proteinuria and albuminuria, reduced glomerular filtration, progressive chronic kidney disease (CKD). As a result, increased risk of end-stage renal disease (ESRD). Further research is necessary to enhance the management of urinary tract infections in individuals with type 2 diabetes.

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