Endocrine Abstracts

Introduction: The gut microbiota plays an important role in host metabolism, immunity, digestibility and even a behavior. Candida spec. is common resident of the gastrointestinal tract and integral part of the microbiota. Number of 10¹ to 10³ fungal cells per g stool are considered as normal range. However, when mucosal surface is disrupted or host immunity is compromised, life-threatening invasive infection can ensue.

Objective: The aim of the study was to evaluate if positive Candida cultures in the stool, influence metabolic parameters in type 2DM patients.

Patients and methods: The study included 46 patients with type 2 DM (20 women and 26 men), 30 -77 years old, with oral antidiabetic treatment (metformin and glimepiride or gliclazide). Beside medical history and clinical examination, all patients were tested for coproculture, fasting glycaemia (FPG), HbA1C, total cholesterol (Hol) triglycerides (Tg), high density lipoproteins (HDL) and low density lipoproteins (LDL).

Results: All patients were divided into following groups: study group (S=18 patients with positive Candida sp. cultures in stool; 39.13%) and control group (C=remaining 28 patients; 60.87%). Comparing the average age in S and C group (68.21 ± 10.4 vs. 66.97 ± 9.7 years), no statistical significance was obtained. Study group patients had a higher BMI compared to the control group (31.41 ± 5.29 vs. 25.18 ± 3.58; P<0.001). Higher values of Tg (2.03 ± 1.13 vs 1.80 ± 0.58), Hol (5.23 ± 1.23 vs 4.73 ± 0.92), LDL (3.27 ± 0.75 vs 2.86 ± 0.83) and HDL (1.63 ± 0.25 vs 1.08 ± 0.44) were verified in study group, compared to the control group, but without statistical significance. HbA1C values were significantly higher in study group patients (9.8 % ± 1.74 vs 6.9% ± 1.89; P<0.05) as well as FPG (10.87 ± 1.35 vs 7.47 ± 1.03; P<0.01).

Conclsion: Type 2DM patients with positive Candida sp. have higher FPG, HbA1C and BMI. Uncontroled glycoregulation is one of the host condition which favors candida colonization and subsequent infection. This may be related to the decrease in commensal bacteria-probably the result of yeast-bacterial competition. On the other hand, we have to keep in mind, that a significantly increased number of Candida colonies can affect the rate of digestion and absorption of carbohydrates and consequently increase the level of glycaemia in patients with diabetes.