Growing importance of urogenital candidiasis in individuals with diabetes: A narrative review

Table 1 Keywords, database, and search time

Keywords	MeSH term	Database
Balanitis	Balanitis	PubMed, Scopus, RCA
Balanoposthitis	-	PubMed, Scopus, RCA
Vulvovaginitis	Vulvovaginitis	PubMed, Scopus, RCA
Urogenital infections	Urogenital system; infections; pathogenicity	PubMed, Scopus, RCA
Pregnancy	Pregnancy	PubMed, Scopus, RCA
Candida	Candida	PubMed, Scopus, RCA
Candidiasis	Candidiasis	PubMed, Scopus, RCA
Diabetes	Diabetes mellitus; diabetes insipidus	PubMed, Scopus, RCA

RCA: Reference Citation Analysis.

Table 2 Biofilm production process

Phase	Phase name	Description
1	Adherence	In the first 3 h, individual C. albicans cells adhere to the substrate, which forms the basal layer of the biofilm
2	Intermediate phase	In 11-14 h, biofilm is shaped during this phase of cell proliferation and filamentation, in which the formation of hyphae occurs, marking the beginning of true biofilm formation
3	Maturation phase	In 20-48 h, there is a complete penetration of all layers of cells attached to the surface; extracellular polysaccharide matrix accumulates at this stage of maturation
4	Dispersion	After 24 h, the final phase involves separation of non-adherent cells from the biofilm, resulting in possible development of new biofilms and dissemination in the tissue

C. albicans: Candida albicans.

Table 3 Studies of the prevalence of candidiasis in individuals with diabetics

Ref.	Yr	Study population	Study outcome
Goswami et al[64]	2000	n = 78 diabetics, n = 88 non-diabetics	A total of 46% of diabetic patients showed vaginal Candida sp. and 23% healthy subjects demonstrated Candida spp.
Goswami et al[65]	2006	n = 85 diabetics, n = 62 non-diabetics	A total of 67.1% of diabetic patients showed vaginal Candida spp. and 47.3% healthy subjects demonstrated Candida spp. following fluconazole treatment
Gunther et al[30]	2014	n = 48 diabetics; n = 669 non-diabetics	A total of 18.8% of diabetics showed vaginal Candida spp. and 11.8% healthy subjects demonstrated Candida spp.
Yokoyama et al[5]	2019	65 diabetic patients	A total of 36.9% of diabetic patients converted to a positive vaginal Candida spp.
Halteet et al[62]	2020	550 diabetic patients	A total of 15.6% of diabetics showed vaginal Candida spp.
Lisboa et al[71]	2010	n = 38 diabetics; n = 440 non-diabetics	A total of 26.2% of males had Candida spp. and 18% of males had balanitis; 13.8% of diabetic patients had balanitis
Kofteridis et al[84]	2009	n = 88 diabetics; n = 118 non-diabetics	A total of 12.7% of diabetic patients showed urinary tract Candida spp. and 1.7% healthy subjects demonstrated Candida spp.
Yismaw et al[90]	2013	422 diabetic patients; n = 387 with asymptomatic UTI; n = 35 with symptomatic UTI	A total of 17.1% of symptomatic diabetic patients showed significant candiduria and 7.5% of asymptomatic diabetic patients
Falahati et al[91]	2016	305 diabetic patients	A total of 12.5% of diabetic patients were positive for candiduria
Esmailzadeh et al[89]	2018	400 diabetic patients	A total of 10% of diabetic patients showed Candida spp. in the urinary tract
Gharanfoli et al[92]	2019	500 patients with UTI; n = 106 diabetics; n = 394 non-diabetics	A total of 21.1% of diabetic patients showed Candida sp. in urinary tract and 4.2% of UTI patients were positive for Candida spp.

UTI: Urinary tract infections.