Can Diabetes Mellitus affect Candida species diversity? A narrative review
Can Diabetes Mellitus affect Candida species diversity? A narrative review
Nazanin Kazemian,1,*Maryam Jafari,2Mohammad Amoozadeh,3
1. Student research committee, Anzali International Medical Campus, Guilan University of Medical Sciences 2. Student research committee, Anzali International Medical Campus, Guilan University of Medical Sciences 3. Student research committee, Anzali International Medical Campus, Guilan University of Medical Sciences
Introduction: Diabetes is a pervasive chronic metabolic disorder that afflicts millions globally. In addition to the primary complications associated to diabetes, such as cardiovascular disease and neuropathy, recent research has unveiled a potential connection between diabetes and Candida infections. Candida, a genus of opportunistic fungi, is ubiquitously distributed within the human body, colonizing sites including the gastrointestinal tract, skin, and mucous membranes. This narrative review aims to meticulously scrutinize the intricate relationship between distinct Candida species and diabetes, elucidating the underlying mechanisms and potential therapeutic implications.
Methods: This comprehensive literature search was meticulously executed, encompassing various databases, notably PubMed, Scopus, and Google Scholar. The search parameters incorporated keywords such as "Candida," "diabetes," "Candida and diabetes," "Candida species," and "diabetes complications." This review encompasses pertinent articles published in the English language over the preceding two decades.
Results: 1. Species-Specific Prevalence: Research consistently unveils Candida albicans as the predominant species in both diabetic and non-diabetic populations. However, individuals with diabetes exhibit heightened susceptibility to other Candida species, prominently Candida glabrata and Candida tropicalis, which are relatively infrequent in healthy cohorts.
2. Glycemic Control and Candida: Findings substantiate a direct correlation between glycemic control and Candida infections. Inadequate diabetes management, marked by elevated blood glucose levels, significantly augments the incidence of Candida infections. This underscores the imperative nature of maintaining optimal blood glucose levels to ameliorate Candida-related complications in diabetes.
3. Biofilm Formation: Research convincingly demonstrates that Candida species, particularly Candida albicans, intricately fashion biofilms on mucosal surfaces in diabetic individuals. These biofilms exhibit remarkable resistance to therapeutic interventions, engendering persistent and recurrent infections, thereby complicating diabetes management.
4. Species-Specific Antifungal Resistance: Studies meticulously delineate variations in antifungal susceptibility among disparate Candida species. Notably, Candida glabrata frequently manifests reduced responsiveness to commonplace antifungal agents, posing formidable challenges in the treatment of diabetic patients.
5. Immune Response: Investigations unveil compromised immune responses within diabetic individuals, characterized by impaired neutrophil and macrophage function. This compromised immune defense substantially heightens susceptibility to Candida infections, particularly in instances of uncontrolled diabetes.
Conclusion: The relationships between Candida species and diabetes are multifaceted and intricate. Through the application of advanced molecular methodologies and the inclusion of diverse patient cohorts, researchers have gleaned critical insights. These findings underscore the paramount importance of glycemic control, the prevalence of specific Candida species, the pivotal role of biofilm formation, and the variances in antifungal resistance. Comprehending these intricate relationships is pivotal for the development of tailored treatment strategies and the enhancement of outcomes for diabetic individuals. Ongoing research in this realm promises to further refine our understanding of these intricate interactions.