---
title: "Asymptomatic Pyuria in Type 2 Diabetes: Prevalence, Glycemic Associations, and Microbiology"
id: "pubmed-42684000"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42684000"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42684000/"
doi: "10.4103/aam.aam_425_26"
published_at: "2026-09-02T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Asymptomatic Pyuria in Type 2 Diabetes: Prevalence, Glycemic Associations, and Microbiology
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42684000
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42684000/)
- **DOI:** [10.4103/aam.aam_425_26](https://doi.org/10.4103%2Faam.aam_425_26)
- **Published At:** 2026-09-02T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective cross-sectional study evaluated **asymptomatic pyuria (ASP)** in 2,843 patients with type 2 diabetes mellitus (T2DM) seen at a tertiary endocrinology outpatient clinic between June 2018 and May 2020. - ASP was defined as >10 leukocytes per high-power field on urine microscopy. The overall prevalence of ASP was 14.98%. - Prevalence differed markedly by sex: 30.7% in females versus 6.87% in males (P < 0.0001). - Patients with ASP were older and had significantly higher postprandial plasma glucose (PPG) and glycated hemoglobin (HbA1c) compared with patients without ASP. - Urinalysis abnormalities including **nitrituria**, **proteinuria**, and **glucosuria** were more common among patients with ASP. - Urine cultures were available for 84 patients; 61.9% of these cultures showed significant bacterial growth. Gram-negative organisms predominated; **Escherichia coli** accounted for 69.2% of isolates. - A notable proportion of isolates demonstrated multidrug resistance (authors reported a substantial fraction but specific resistance rates were not detailed in the abstract). - The authors conclude ASP affects about 15% of T2DM patients, is more frequent in women, and is associated with poorer glycemic control and urinary abnormalities. They note that culture positivity and antimicrobial resistance raise questions about the clinical significance and management of ASP in T2DM and call for further study.
## Clinical Analysis & Structured Key Points
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Online ahead of print. # Prevalence of Asymptomatic Pyuria in Patients with Type 2 Diabetes Mellitus and Its Association with Glycemia [Article in French, English] [S L Sagar Reddy](https://pubmed.ncbi.nlm.nih.gov/?term=Reddy+SLS&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Sumanasa Gopala Datta](https://pubmed.ncbi.nlm.nih.gov/?term=Datta+SG&cauthor_id=42684000)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-2 "Department of Endocrinology, Aster Ramesh Hospital, Vijayawada, Andhra Pradesh, India."), [Umalakshmi Annavarapu](https://pubmed.ncbi.nlm.nih.gov/?term=Annavarapu+U&cauthor_id=42684000)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-3 "Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Satish Kumar Samal](https://pubmed.ncbi.nlm.nih.gov/?term=Samal+SK&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Ranjini Chittur Yerat](https://pubmed.ncbi.nlm.nih.gov/?term=Yerat+RC&cauthor_id=42684000)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-4 "Department of Microbiology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Mohammed Mahrous](https://pubmed.ncbi.nlm.nih.gov/?term=Mahrous+M&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Tanedhar Meghanath Bhargav Theja](https://pubmed.ncbi.nlm.nih.gov/?term=Theja+TMB&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Ranjith Mule](https://pubmed.ncbi.nlm.nih.gov/?term=Mule+R&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Melkunte Shanthaiah Dhananjaya](https://pubmed.ncbi.nlm.nih.gov/?term=Dhananjaya+MS&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Vijaya Sarathi](https://pubmed.ncbi.nlm.nih.gov/?term=Sarathi+V&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#full-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.") Affiliations Expand ### Affiliations * 1 Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. * 2 Department of Endocrinology, Aster Ramesh Hospital, Vijayawada, Andhra Pradesh, India. * 3 Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. * 4 Department of Microbiology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. * PMID: **42684000** * DOI: [ 10.4103/aam.aam_425_26 ](https://doi.org/10.4103/aam.aam_425_26) Item in Clipboard # Prevalence of Asymptomatic Pyuria in Patients with Type 2 Diabetes Mellitus and Its Association with Glycemia [Article in French, English] S L Sagar Reddy et al. Ann Afr Med. 2026. Show details Display options Display options Format Abstract PubMed PMID Ann Afr Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Ann+Afr+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Ann+Afr+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42684000/) . 2026 Sep 2. doi: 10.4103/aam.aam_425_26. Online ahead of print. ### Authors [S L Sagar Reddy](https://pubmed.ncbi.nlm.nih.gov/?term=Reddy+SLS&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Sumanasa Gopala Datta](https://pubmed.ncbi.nlm.nih.gov/?term=Datta+SG&cauthor_id=42684000)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-2 "Department of Endocrinology, Aster Ramesh Hospital, Vijayawada, Andhra Pradesh, India."), [Umalakshmi Annavarapu](https://pubmed.ncbi.nlm.nih.gov/?term=Annavarapu+U&cauthor_id=42684000)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-3 "Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Satish Kumar Samal](https://pubmed.ncbi.nlm.nih.gov/?term=Samal+SK&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Ranjini Chittur Yerat](https://pubmed.ncbi.nlm.nih.gov/?term=Yerat+RC&cauthor_id=42684000)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-4 "Department of Microbiology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Mohammed Mahrous](https://pubmed.ncbi.nlm.nih.gov/?term=Mahrous+M&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Tanedhar Meghanath Bhargav Theja](https://pubmed.ncbi.nlm.nih.gov/?term=Theja+TMB&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Ranjith Mule](https://pubmed.ncbi.nlm.nih.gov/?term=Mule+R&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Melkunte Shanthaiah Dhananjaya](https://pubmed.ncbi.nlm.nih.gov/?term=Dhananjaya+MS&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India."), [Vijaya Sarathi](https://pubmed.ncbi.nlm.nih.gov/?term=Sarathi+V&cauthor_id=42684000)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42684000/#short-view-affiliation-1 "Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India.") ### Affiliations * 1 Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. * 2 Department of Endocrinology, Aster Ramesh Hospital, Vijayawada, Andhra Pradesh, India. * 3 Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. * 4 Department of Microbiology, Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India. * PMID: **42684000** * DOI: [ 10.4103/aam.aam_425_26 ](https://doi.org/10.4103/aam.aam_425_26) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42684000/#eng-abstract) [ French ](https://pubmed.ncbi.nlm.nih.gov/42684000/#fra-abstract) **Background:** Type 2 diabetes mellitus (T2DM) is associated with an increased risk of urinary tract infections, including asymptomatic forms like asymptomatic bacteriuria or asymptomatic pyuria (ASP). However, the association between ASP (defined as elevated urinary leukocyte count without symptoms) and glycemic control remains unclear. Hence, this study was conducted to determine the prevalence of ASP in patients with T2DM and evaluate its association with glycemic parameters and urinary abnormalities. **Methods:** This retrospective cross-sectional study included 2843 T2DM patients attending the endocrinology outpatient department of a tertiary care center between June 2018 and May 2020. Data on urine microscopy, fasting plasma glucose, postprandial plasma glucose (PPG), and glycated hemoglobin (HbA1c) were analyzed. ASP was defined as >10 leukocytes per high-power field in urine. **Results:** The prevalence of ASP was 14.98%, significantly higher in females than males (30.7% vs. 6.87%, P < 0.0001). Patients with ASP were older and had significantly higher PPG and HbA1c levels compared to those without ASP. Nitrituria, proteinuria, and glucosuria were also more frequent in the ASP group. Among patients with available urine cultures (n = 84), 61.9% showed significant bacterial growth, predominantly Gram-negative organisms, with Escherichia coli being the most common isolate (69.2%). A notable proportion of isolates exhibited multidrug resistance. **Conclusions:** ASP is present in approximately 15% of T2DM patients, with higher prevalence in females and association with poor glycemic control and urinary abnormalities. Given the substantial proportion of culture positivity and antimicrobial resistance, further studies are needed to clarify the clinical significance and management implications of ASP in T2DM. **Résumé** **Contexte:** Le diabète de type 2 (DT2) est associé à un risque accru d’infections urinaires, y compris les formes asymptomatiques telles que la bactériurie asymptomatique ou la pyurie asymptomatique (ASP). Toutefois, le lien entre l’ASP (définie par un nombre élevé de leucocytes urinaires en l’absence de symptômes) et le contrôle glycémique reste mal élucidé. Cette étude a donc été menée pour déterminer la prévalence de l’ASP chez les patients atteints de DT2 et pour évaluer son association avec les paramètres glycémiques et les anomalies urinaires.**Méthodes:** Cette étude transversale rétrospective a porté sur 2 843 patients atteints de DT2 suivis en consultation externe d’endocrinologie dans un centre de soins tertiaires entre juin 2018 et mai 2020. Les données relatives à l’examen microscopique des urines, à la glycémie à jeun, à la glycémie postprandiale (GPP) et à l’hémoglobine glyquée (HbA1c) ont été analysées. L’ASP a été définie par la présence de plus de 10 leucocytes par champ à fort grossissement dans les urines.**Résultats:** La prévalence de l’ASP était de 14,98 %, significativement plus élevée chez les femmes que chez les hommes (30,7 % contre 6,87 %, P < 0,0001). Les patients présentant une ASP étaient plus âgés et affichaient des taux de GPP et d’HbA1c significativement plus élevés que ceux sans ASP. La nitriturie, la protéinurie et la glycosurie étaient également plus fréquentes dans le groupe ASP. Parmi les patients ayant bénéficié d’un examen cytobactériologique des urines (n = 84), 61,9 % présentaient une prolifération bactérienne significative, principalement due à des germes à Gram négatif, Escherichia coli étant l’isolat le plus fréquent (69,2 %). Une proportion notable d’isolats présentait une multirésistance aux antibiotiques.**Conclusions:** L’ASP est présente chez environ 15 % des patients atteints de DT2; sa prévalence est plus élevée chez les femmes et elle est associée à un mauvais contrôle glycémique ainsi qu’à des anomalies urinaires. Compte tenu de la proportion importante de cultures positives et de résistance aux antimicrobiens, d’autres études sont nécessaires pour préciser la signification clinique et les implications en matière de prise en charge de l’ASP chez les patients atteints de DT2. **Keywords:** Asymptomatic bacteriuria; Bactériurie asymptomatique; asymptomatic pyuria; diabète de type 2; pyurie asymptomatique; type 2 diabetes mellitus. Copyright © 2026 Annals of African Medicine. 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