Objective: A positive relationship exists between high blood glucose levels and infection prevalence in patients with diabetes. Hyperglycemia may predispose to fungal infections. This study was conducted to compare the frequency of fungal infections and antifungal agent resistance of culture strains in children with type 1 diabetes mellitus (T1DM) with those in healthy controls and to assess the relationship between fungal infection and hemoglobin A1c (HbA1c) levels.
Materials and Methods: The study population included 67 girls with T1DM and 63 girls without T1DM, immunodeficiency, or chronic drug use. Blood and urine samples were collected, and genital smear sampling was performed. Samples were evaluated in a mycology laboratory, and fluconazole sensitivity of culture samples was determined.
Results: Genital complaints were more common among patients with diabetes. Fungal agents were isolated in 55.22% of patients with diabetes, where Candida glabrata was the most common strain isolated (46.0%). Meanwhile, Candida albicans was more common in the control group (40.0%). All strains were fluconazole-sensitive, as strains with native resistance were excepted. For serum HbA1c levels, a cutoff value of 8.9 was identified and was related to fungal growth with a reliability of 80%. Patients with diabetes for more than 12 months had a higher risk of fungal infection.
Conclusion: Patients with serum HbA1c levels of more than 8.9 and a diabetes duration of more than 12 months should be assessed for fungal infections, and genital smear samples should be obtained periodically during follow-up.