Iberoamerican Journal of Medicine
https://iberoamjmed.com/article/doi/10.5281/zenodo.4495286
Iberoamerican Journal of Medicine
Review

Candida species oral detection and infection in patients with diabetes mellitus: a meta-analysis

Alberto Rodríguez-Archilla, Claudia Piedra-Rosales

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Abstract

Introduction: Diabetes mellitus is a chronic metabolic disorder that induces elevated plasma glucose levels. Diabetic patients are more susceptible to infections, especially fungal infections. There is a direct relationship between increased blood glucose levels and the number of Candida hyphae in the oral mucosa. This study aimed to evaluate oral candidiasis and the different Candida species found in patients with and without diabetes mellitus.
Methods: A search for studies on oral candidiasis and diabetes mellitus was carried out in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS) and Google Scholar. For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratios (OR) using the Mantel-Haenszel (M-H) method with 95% confidence intervals.
Results: 25 studies were included in this meta-analysis. Diabetes Mellitus patients tripled the probability of being infected by Candida species (OR:3.16, p<0.001). Likewise, Candida species infections were more likely in patients with poor glycemic control (OR:2.94, p<0.001) and with dentures (OR:2.22, p<0.001). In contrast, neither gender nor diabetes mellitus type of diabetes conditioned fungal infections (p>0.05). The most prevalent Candida species in both diabetics and controls were C. albicans and C. tropicalis. Diabetics had significantly fewer C. non-albicans species oral infections than non-diabetics (p=0.04).
Conclusions: Diabetics are more prone to oral candidiasis, especially C. albicans infections.

Keywords

Blood glucose; Oral candidiasis; Diabetes mellitus; Risk factors

References

1. Butler AE, Misselbrook D. Distinguishing between type 1 and type 2 diabetes. BMJ. 2020;370:m2998. doi: 10.1136/bmj.m2998.
2. Bastos AS, Leite AR, Spin-Neto R, Nassar PO, Massucato EM, Orrico SR. Diabetes mellitus and oral mucosa alterations: prevalence and risk factors. Diabetes Res Clin Pract. 2011;92(1):100-5. doi: 10.1016/j.diabres.2011.01.011.
3. Martorano-Fernandes L, Dornelas-Figueira LM, Marcello-Machado RM, Silva RB, Magno MB, Maia LC, et al. Oral candidiasis and denture stomatitis in diabetic patients: Systematic review and meta-analysis. Braz Oral Res. 2020;34:e113. doi: 10.1590/1807-3107bor-2020.vol34.0113.
4. Wells G, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. Ottawa (Canada): The Ottawa Hospital. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp (accessed Nov 2020).
5. Al-Attas SA, Amro SO. Candidal colonization, strain diversity, and antifungal susceptibility among adult diabetic patients. Ann Saudi Med. 2010;30(2):101-8. doi: 10.4103/0256-4947.60514.
6. Ayinampudi BK, Chervu AR, Raju SB, Pacha VB. Oral Candida colonization in renal disease patients between diabetes and non-diabetes; a comparative study. Immunopathol Persa. 2018;4(1):e08. doi: 10.15171/ipp.2018.08.
7. Babatzia A, Papaioannou W, Stavropoulou A, Pandis N, Kanaka-Gantenbein C, Papagiannoulis L, et al. Clinical and microbial oral health status in children and adolescents with type 1 diabetes mellitus. Int Dent J. 2020;70(2):136-44. doi: 10.1111/idj.12530.
8. Balan P, B Gogineni S, Kumari N S, Shetty V, Lakshman Rangare A, L Castelino R, et al. Candida Carriage Rate and Growth Characteristics of Saliva in Diabetes Mellitus Patients: A Case-Control Study. J Dent Res Dent Clin Dent Prospects. 2015;9(4):274-9. doi: 10.15171/joddd.2015.048.
9. Bartholomew GA, Rodu B, Bell DS. Oral candidiasis in patients with diabetes mellitus: a thorough analysis. Diabetes Care. 1987;10(5):607-12. doi: 10.2337/diacare.10.5.607.
10. Belazi M, Velegraki A, Fleva A, Gidarakou I, Papanaum L, Baka D, et al. Candidal overgrowth in diabetic patients: potential predisposing factors. Mycoses. 2005;48(3):192-6. doi: 10.1111/j.1439-0507.2005.01124.x.
11. Bissong M, Azodo CC, Agbor MA, Nkuo-Akenji T, Fon PN. Oral health status of diabetes mellitus patients in Southwest Cameroon. Odontostomatol Trop. 2015;38(150):49-57.
12. Farooq A, Khadija K, Younas A. The incidence of oral candidiasis in diabetes. IAJPS. 2018;05(12):14309-12.
13. Guggenheimer J, Moore PA, Rossie K, Myers D, Mongelluzzo MB, Block HM, et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies: II. Prevalence and characteristics of Candida and Candidal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89(5):570-6. doi: 10.1067/moe.2000.104477.
14. Hill LV, Tan MH, Pereira LH, Embil JA. Association of oral candidiasis with diabetic control. J Clin Pathol. 1989;42(5):502-5. doi: 10.1136/jcp.42.5.502.
15. Jafari AA, Khanpayah E, Ahadian H. Comparison the Oral Candida Carriage in Type 2 Diabetic and Non Diabetics. Jundishapur J Microbiol. 2013;6(7):e8495. doi: 10.5812/jjm.8495.
16. Javed F, Ahmed HB, Mehmood A, Saeed A, Al-Hezaimi K, Samaranayake LP. Association between glycemic status and oral Candida carriage in patients with prediabetes. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117(1):53-8. doi: 10.1016/j.oooo.2013.08.018.
17. Jhugroo C, Divakar DD, Jhugroo P, Al-Amri SAS, Alahmari AD, Vijaykumar S, et al. Characterization of oral mucosa lesions and prevalence of yeasts in diabetic patients: A comparative study. Microb Pathog. 2019;126:363-7. doi: 10.1016/j.micpath.2018.11.028.
18. Kadir T, Pisiriciler R, Akyüz S, Yarat A, Emekli N, Ipbüker A. Mycological and cytological examination of oral candidal carriage in diabetic patients and non-diabetic control subjects: thorough analysis of local aetiologic and systemic factors. J Oral Rehabil. 2002;29(5):452-7. doi: 10.1046/j.1365-2842.2002.00837.x.
19. Kumar BV, Padshetty NS, Bai KY, Rao MS. Prevalence of Candida in the oral cavity of diabetic subjects. J Assoc Physicians India. 2005;53:599-602.
20. Kumar S, Padmashree S, Jayalekshmi R. Correlation of salivary glucose, blood glucose and oral candidal carriage in the saliva of type 2 diabetics: A case-control study. Contemp Clin Dent. 2014;5(3):312-7. doi: 10.4103/0976-237X.137925.
21. Matic Petrovic S, Radunovic M, Barac M, Kuzmanovic Pficer J, Pavlica D, Arsic Arsenijevic V, et al. Subgingival areas as potential reservoirs of different Candida spp in type 2 diabetes patients and healthy subjects. PLoS One. 2019;14(1):e0210527. doi: 10.1371/journal.pone.0210527.
22. Mohammadi F, Javaheri MR, Nekoeian S, Dehghan P. Identification of Candida species in the oral cavity of diabetic patients. Curr Med Mycol. 2016;2(2):1-7. doi: 10.18869/acadpub.cmm.2.2.4.
23. Obradović RR, Kesić LG, Pejčić AA, Petrović MS, Živković ND, Živković DM. Diabetes mellitus and oral candidiasis. Acta Stomatol Naissi. 2011;27(63):1025-34. Doi: 10.5937/asn1163025O.
24. Lydia Rajakumari M, Saravana Kumari P. Prevalence of Candida species in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry. J Mycol Med. 2016;26(4):359-67. doi: 10.1016/j.mycmed.2016.08.002.
25. Sampath A, Weerasekera M, Dilhari A, Gunasekara C, Bulugahapitiya U, Fernando N, et al. Type 2 diabetes mellitus and oral Candida colonization: Analysis of risk factors in a Sri Lankan cohort. Acta Odontol Scand. 2019;77(7):508-16. doi: 10.1080/00016357.2019.1607547.
26. Sampath A, Weerasekera M, Gunasekara C, Dilhari A, Bulugahapitiya U, Fernando N. A sensitive and a rapid multiplex polymerase chain reaction for the identification of Candida species in concentrated oral rinse specimens in patients with diabetes. Acta Odontol Scand. 2017;75(2):113-22. doi: 10.1080/00016357.2016.1265146.
27. Shenoy MP, Puranik RS, Vanaki SS, Puranik SR, Shetty P, Shenoy R. A comparative study of oral candidal species carriage in patients with type1 and type2 diabetes mellitus. J Oral Maxillofac Pathol. 2014;18(Suppl 1):S60-5. doi: 10.4103/0973-029X.141361.
28. Trentin MS, Verardi G, De C Ferreira M, de Carli JP, da Silva SO, Lima IF, et al. Most Frequent Oral Lesions in Patients with Type 2 Diabetes Mellitus. J Contemp Dent Pract. 2017;18(2):107-11. doi: 10.5005/jp-journals-10024-1999.
29. Zomorodian K, Kavoosi F, Pishdad GR, Mehriar P, Ebrahimi H, Bandegani A, et al. Prevalence of oral Candida colonization in patients with diabetes mellitus. J Mycol Med. 2016;26(2):103-10. doi: 10.1016/j.mycmed.2015.12.008.


Submitted date:
12/28/2020

Reviewed date:
01/27/2021

Accepted date:
01/30/2021

Publication date:
02/02/2021

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