Prevalence of pathogenic yeasts and humoral antibodies to candida in diabetic patients.

Abstract

SUMMARY The prevalence of oral yeasts and humoral precipitating antibodies to candida was estimated in 204 unselected diabetic patients (172 outpatients and 32 inpatients). Yeasts, mainly Candida albicans, were isolated from the mouths of 41 % of the outpatients and precipitins were found in 17-5 % although none of the patients had clinically overt candidiasis. The extent of oral yeast colonisation and incidence of antibodies was not related to their antidiabetic treatment or to the duration of their diabetes. It was, however, related to the blood glucose and urine sugar levels at the time they were sampled, the highest incidence being among the diabetic inpatients with high blood glucose levels at the time of sampling and the lowest among outpatients with normal blood glucose levels at the time of sampling. There was no such correlation when diabetic control over the previous 12-month period was considered.

Factors influencing oral carriage of yeasts among individuals with diabetes mellitus

“…In this study only 54 % of the isolates were C. albicans (Table 2); this figure includes the proportion that was not identified by API 20C Aux as C. albicans but found to be so by conventional methods. These results are similar to studies which found 60 % of isolates from diabetics to be C. albicans [3,16]. This emphasizes the need for accurate identification as patients with diabetes are more likely to carry and to have disease due to species other than C. albicans [18] which might not be sensitive to routinely prescribed oral antifungal agents [19].…”

“…In this study, 66 % of the diabetics were carriers of yeasts by the oral rinse technique, a figure slightly higher than those reported in previous studies of diabetics (41-62%) [2,3,5,6,16].…”

“…C. glabrata and C. tropicalis were isolated more frequently from patients with either IDDM or NIDDM who wore dentures. There were significantly more carriers among individuals with IDDM compared with NIDDM subjects; no other study has found this association [2,3,16]. This might be due to the smaller sample sizes of other studies, differences in populations sampled and their distinction of IDDM from NIDDM based solely on treatment of the diabetic condition.…”

Identification of Candidal Species from the Oral Cavity of Diabetic and Non-Diabetic Groups

“…The increased candidal colonization in diabetic patients could be attributed to the promotion of the binding of Candida to epithelial cells and reduction of tissue resistance against infection. Likewise, salivary glucose and pH levels are correlated with the increased carriage rate of Candida in diabetic patients [16][17][18] . In the present study, diabetic patients aged 40-60 years old with high salivary glucose, low salivary pH, history of xerostomia, and low oral hygiene showed more than 50 colonies of Candida in their mouth.…”

Host factors affecting oral candidiasis

“…1 It is accepted that high salivary glucose levels among diabetics favour the growth of yeasts. 17,37 However, some investigators have not been able to show a relationship between glycaemic control and oral carriage. 38,39 It seems that defects in Candida-cidal activity of neutrophils, particularly in the presence of glucose may promote oral carriage of Candida among diabetics.…”