'The Diagnosing Diabetes Mellitus Health And Social Care Essay\r'

'This was a font visualise measure, which was conducted at the Mahatma Gandhi medical checkup College and Research get Hospital, Puducherry, a rural Tertiary attention hospital with an one(a)-year volume of to a higher place 1,00,000 perseverings over one twelvemonth period.\r\nThe Institutional Medical Ethics military commission approved this visual sense. From January 2011 until April 2012 we enrolled patients amidst the hop ons of 14 and 86 quondam(a) eras of age.\r\n blow diabetes mellitus patients and 50 healthy not diabetic controls without any urinary ailments viz dysuria, frequence, urgency, strangury, tenesimus, nocturia, nocturnal urinary incontinence, prostatism, incontinency, urethral hurting, vesica hurting, renal gripes, prostate hurting, and who attended Mahatma Gandhi Medical College mingled with August 2010 to July 2012 were enrolled for this suss out. These patients did non h nonagenarian any old vesica catheterisation, instrumentality of urogenital foregather of ground or old urogenital surgery.\r\nWHO criteria was applied to charge diabetes mellitus.WHO criteria for naming diabetes mellitus.Methods and standards for naming diabetes mellitus1. Diabetess symptoms ( ie polyuria, polydipsia and unexplained tilt loss ) plus\r\na random venous rake snag plasma glucose preoccupancy & A ; gt ; 11.1 mmol/lora fasting plasma glucose concent proportionalityn & A ; gt ; 7.0 mmol/l ( whole blood & A ; gt ; 6.1mmol/l )ortwo hr plasma glucose submerging & A ; gt ; 11.1 mmol/l two hours after 75g anhydrous glucose in an unwritten glucose tolerance trial ( OGTT ) .\r\n2. without symptoms analyse of DM should non be based on a individual glucose trial except requires collateral plasma venous puzzleing. At least two glucose trials egress on a opposite twenty-four hours with a value within the diabetic scope is indispensable. It pile be either fasting, random way of lifel or the two hr station glucose tria l. If the fasting glucose or random glucose values be non symptomatic of DM so the two hr value should be used.MethodDuring initial visit relevant facts were elicited from patients prattle history, age, protraction of diabetes, absence of urinary symptoms. H/O old catheterisation, instrumentality and surgery of urogenital piece of republic. With respect to young-bearing(prenominal) patients, their catamenial history, H/O white discharge. H/O pruritus vulva were elicited.\r\nThen clear up scrutiny of patients carried out peculiarly with respect to complications of diabetes. In priapic patients, per rectal scrutiny was carried out to enjoin out prostate expansion routinely. In effeminate patients elabo wander gynecological scrutiny carried out to rule out any gynecological jobs, cystocele etcetera\r\nAfter these preliminary scrutinies, patients non suiting into choice standards were omitted, and 100 diabetes mellitus patients, and 50 non diabetic control were proceeded to surveiling frame of stick with.\r\nDuring subsequent visits, patients and command assort random blood colewort power points, blood carba middlee, serum creatinine trials were done. On the aforementioned(prenominal) twenty-four hours patients weewee samples were collected for cultivation and microscopic scrutiny. In womanly patients egesting nuance sample were collected during their non-menstural periods.METHODS OF URINE SPECIMEN COLLECTIONClean gimmick mid watercourse urine aggregation method was adopted.\r\nPatients were explained around the methods of roll uping clean gimmick midstream piss and olden fe antheral patients were provided with nursing helpers for cleaning the external genital organ.\r\nUrine was collected in a sterilized wide-mouthed prison guard cap bottle for cultivation intent and microscopic scrutiny. Two back-to-back urine specimens were obtained, and refrigerated instantly, because it was non possible to plate all in all the samples of urine in stantly.\r\nOne elegance of a clean-voide specimen of midstream piss from an person without symptoms of a UTI with at least one hundred five cfu/ml of the same individual bacterial species was considered agree to name ASB [ 30 ] .\r\nThe ground to elaboration a 2nd clip is to know apart between true bacteriuria and taint. In almost surveies, merely the authoritative purifications atomic number 18 restate to name [ 30 ] .Quantitative refining OF URINEUrine was cultured quantitatively by graduated loop topology technique. The civilization home bases were read at the storehouse of 24 hours and no. of settlements counted in absolute civilizations. If in that location was no growing the civilization home bases were reincubated for another 24 hours and figure of settlements calculated if growing was remark.ANTIBIOTIC predisposition TESTSThese were done utilizing the standard sums of ( nitrofurantoin, tetracycline, aminoglycosides, co-trimaxazole,third coevals Mefoxins, fl uroquinolones, ? lactams and nalidixic acid in all civilization positive instances ) and study obtained at the terminal of 48 hours.\r\nIt was non possible to gauge HbA1C in all the patients in our set-up.\r\nWritten informed have was obtained from the patients and controls.\r\nWe excluded all patients who had factors favoring exclusion standards and include patients who satisfied inclusion body standards.Data CollectionAll information was entered into a Data Collection Proforma tacking ( Appendix 1 ) and were entered into pass ( MS Excel 2011 ) . The Sheet had a ocular map for taging and change integrity into indicants for two genders. separate biographical inside informations were anyways collected including day of the month of birth, weight and tallness.Statistical MethodsStatistical abbreviation was carried out utilizing SPSS version 19.0 ( IBM SPSS, US ) package with regression toward the mean Modules installed.\r\nStatistical methods such as odds ratio and chisqu ar trials were applied to happen the significance between antithetical variables.\r\nASB\r\nCase\r\ncontrol\r\nPositive\r\n42 [ a ]\r\n3 [ B ]\r\nnegative\r\n58 [ story Celsiuss ]\r\n47 [ vitamin D ]Oddss ratio:ad/bc\r\n= 42×47/58×3\r\n= 11.34\r\ndiabetic patients have 11.34 quantify the estimate to develop asymptomatic bacteruria than a non diabetic person.Chisqu atomic number 18:X2 = ? ( o-e ) 2 vitamin E\r\ndf = 1\r\nX2 = 20.564\r\nP =DiscussionIn this survey an effort was made to find the relative incidence of asymptomatic bacteriuria in diabetes mellitus patients with comparing to non diabetic control aggroup, joint organisms doing infection and their antibiotic drug comminutedness.\r\nOn reexamining the literature the undermentioned surveies conducted in similar mode to the commit survey noted.WriterYearSexual activityPrevalence Rate %Veljlasgaard\r\n1966\r\nboth\r\n9.3\r\n1986\r\nBoth\r\n6.3\r\nSchmitt\r\n1986\r\nF\r\n9.1\r\nKeane\r\n1988\r\nF\r\n3.5 Fold a ddition\r\nKelestimor\r\n1990\r\nF\r\n cadence\r\n31.3\r\n17.4\r\nZhanel\r\n1955\r\nF\r\nMeter\r\n3 be quiet rise\r\nEqual to non diabetic male\r\nZhanel\r\n1955\r\nF\r\n7.9\r\nKayima\r\n1996\r\nF\r\nMeter\r\n28\r\n16\r\nBalasoiu\r\n1997\r\nMeter\r\nF\r\n16\r\n32\r\nVery saturatedly a(prenominal) surveies of this character were carried out in our state.\r\nAs noted above, most of surveies were conducted merely in female symbol II diabetes patients. Prevalence of asymptomatic bacteriuria in female diabetes patients varies from 7.9 % to 32 % . Relatively in the sacrifice survey the incidence of asymtomatic bacteriuria in female case II patients is 35.38 % .\r\nMerely few surveies were conducted in male scourt II patients. Most of the surveies showed the prevalence of symptomless bacteriuria as equal to non-diabetic work forces. But in the present survey incidence of symptomless bacteriuria in male Type II is 20 % compared to 0 % incidence in non-diabetic control. A survey conducted in Type II patients of both sexes showed the prevalence of symptomless bacteriuria as 9.3 % . In the present survey the incidence of symptomless bacteriuria in Type II patients is 26.66 % ( Male 20 % ; Female 40 % ) .\r\nIn the present survey incidence of symptomless bacteriuria in both female and male diabetic patients are in high spirits when compared with non diabetic control group ( 36 % and 20 % and 0 % )\r\nBoth Type II ( insulin ) and Type II ( OHA ) patients are every bit affected ( 26.66 % and 28.33 % ) .\r\n plowshare of male patients with diabetes mellitus on insulin with\r\npositive civilization †20.00 %\r\n circumstances of male patients with diabetes mellitus on OHA with\r\npositive civilization †20.00 %\r\n component of female patients with diabetes mellitus on insulin\r\nwith positive civilization †40.00 %\r\n per centum of male patients with diabetes mellitus on OHA\r\nwith positive civilization †35.00 %\r\n component of patients with diabetes mellitus on insulin\r\nwith positive civilization †26.66 % .\r\nPercentage of patients with diabetes mellitus on\r\nOHA with positive civilization †28.00 %\r\nPercentage of male patients with positive civilization †20.00 %\r\nPercentage of female patients with positive civilization †36.00 %\r\nIn control group no. of male patient with positive civilization †0\r\nIn control group no. of female patient with positive civilization †3\r\nPercentage †12.00 %\r\n more(prenominal) surveies have found that the commonest world doing symptomless bacteriuria is E. coli 40 % , and gram negative B made up 66.7 % of the isolates. Relatively in the present survey, the common world is E.coli ( 57.14 % ) . Other beings isolated include Klebsiella ( 33.33 % ) Enterococci ( 4.76 % ) , Proteus ( 2.38 % ) , acinetobacter ( 2.38 % ) .\r\nBacteriuria appears to confine no relation to increasing age. In the present survey symptomless bacteriuria slip byred i n all age groups. About 55 % of civilization positive causes are in the age group of 41-60 old ages.\r\nBacteruria is common among aged life in non- instituitional community scenes, in particular among boastful females, although non every bit common as among the aged in institutional scenes [ 16 ] .\r\nThe olfactory perception that true bacteruria in the diabetic is chiefly check to aged diabetic big(a) females. Furthermore, the prevalence of bacteriuria among them was importantly greater than that of aged non diabetic females [ 22 ] .\r\n bemire piss is defined as the presence of at least 3 different micro-organisms in 1 urine specimen. [ 4 ]\r\nThe prevalence of ASB is change magnitude in magnanimous females with diabetes [ 26 % vs 6 % ] and might be added to the list of diabetic complications in magnanimous females [ 4 ] .\r\nLonger the sequel of diabetes with the presence of complications apparently increases the opine of ASB in type 1 diabetic cock-a-hoop females [ 4 ] .\r\nThe rate of ASB is non influenced by look of diabetic control [ glycosylated hemoglobin, fasting glucose degree ] or renal map [ 40 ] .\r\nLonger continuance of diabetes, but non glucose control, is associated with bacteriuria prevalence. A statistically important yener diabetes continuance was found for diabetic topics with bacteriuria than without. Prevalence of bacteriuria additions 1.9 †crease quantify in every 10 old ages continuance of diabetes. unless, there was no association between great †term glucose control, as reflected by glycosylated hemoglobin degree, and bacteriuria prevalence [ 34 ] .\r\n well bacteriuria is common, particularly in functionally impaired aged patients with multiple medical morbidities. If symptoms or marks of infections are absent examen with perfunctory dipstick and subsequent healthful interpolation is neither recommended. archeozoic acknowledgment and direction of assorted hazard factors of ASB is genuinely of impor t to potentially cut down its adventure [ 6 ] .\r\nSing all results there is no benefit of analyseing for and discourse of bacteriuria [ 7 ] .\r\nIt is hard to turn out that ASB is more frequent among self-aggrandizing females with diabetes than among those without diabetes [ 8,12 ] .\r\nPrevalence of ASB is about three times high in patients with diabetes when compared with the control subjects [ 11 ] .\r\nPrevalence of bacteriuria was 4.4 times higher among diabetic than non diabetic topics [ 23 ] .\r\nThe prevalence of ASB among patients with diabetes is higher than in an seemingly healthy group [ 24 ] .\r\nThe prevalence of bacteriuria in diabetic big females is 7 % to 13 % , approximately three times higher than not diabetic heavy(p) females [ 28 ] .\r\nASB is improbable to be a effect of pitiful control of diabetes [ 11 ] .\r\nDamage of metabolic control of diabetes as revealed by an addition in HbA1c degree increases the hazard of create ASB [ 8 ] .\r\nDuration of d iabetes, high HbA1c degree, glucosuria and pyuria are risk factors for ASB in patients with type 2 diabetes. E.coli and K.pneumoniae are the most often stray bacteriums in diabetes patients with ASB. Routine urine civilization might be recommended in diabetic patients who show no urinary symptoms but who have one or more of the hazard factors mentioned [ 42 ] .\r\nThe prevalence of ASB and leukocyturia ( & A ; gt ; 5 cells / high power field ) was higher in kids and immature largeups with diabetes than those of control topics and the spectrum of bacteriums in ASB was different from the inveterate spectrum of UTI. There was a inclination in the declension in nephritic map in type 1 diabetic adult females who had ASB [ 44 ] .\r\n symptomless urinary infection can non with certainty be correlated with increasing continuance of diabetes. The prevalence rate of symptomless bacteriuria increased with long continuance of diabetes. In the present survey 30 % of positive civilizatio n instances had diabetes for 1-3yrs continuance. another(prenominal) 24 % instances had diabetes for 5 to 10 year. continuance. point 33.33 % of freshly detected diabetes patients had positive urine civilization. any patient with diabetes can hold symptomless bacteriuria no matter of their continuance of disease.\r\nThe prevalence of symptomless bacteriuria is non affected by steps of glucose control. In the present survey 40 % civilization positive instances had random blood sugar value in the scope of 201 to 250 milligram % . Another 24 % had in the scope of 151 to 200 % . 15 % patients had in the scope of 251 to 300 % . The determination that quality of diabetic control does non uphold the prevalence of symptomless bacteriuria is confirmed.\r\nThe prevalence of symptomless bacteriuria additions as diabetic retinopathy becomes more terrible [ 33 ] , 2 instances of diabetic retinopathy are civilization positive in the present survey.\r\nOf the 6 patients with diabetic nephropat hy 4 instances are civilization positive. A instances of diabetic pes in present survey non had any urinary piece of republic infection. Of the 4 instances with ischaemic bosom disease, 2 instances are civilization positive.\r\nCertain surveies found that isolates were ill in the altogether to on a regular basis for sale antibiotics †Achromycins ( 33 % splendid ) , cotrimaxazole ( 33 % sensitive ) . Other disinfectants with over 80 % sensitiveness degree included aminoglycosides, nitrofurantoin, 3rd coevals cepholosporins and fluroquinolones.\r\nAll the beings that are grown in civilization in the present survey are tolerant to normally used antibiotics bid Achromycins, cotrimaxazole, and nalidixic acid. Almost all isolates are sensitive to quinolone group of drugs. Some are sensitive to aminoglycosides. Most of them were sensitive to nitrofurantoin.\r\nSome of them were scour immune to nitrofurantoin and 3rd coevals Mefoxins.\r\nSome of them were merely sensitive to ex tensive spectrum ?-lactam antibiotic.\r\nNo benefit was idenitified in act show and intervention of symptomless bacteriuria. Antimicrobial therapy cleared bacteriuria in the short term, but did non precipitate the Numberss of symptomatic episodes and hospitalizations during long term cost up, and the high rate of repeated bacteriuria led to markedly increased usage of germicide agents. Increasing antimicrobic opposition is a study concern [ 13 ] .\r\nAntimicrobial direction of urinary piece of place down infection in diabetic adult females should concentrate on the prompt assignment and effectual intervention of symptomatic episodes [ 13 ] .\r\n obscure E.coli separate outs were immune at similar rates to ampicillin, cotrimoxozole, ciprofloxacin and Macrodantin in both diabetic and non-diabetic patients. thereof diabetes mellitus could non considered per se a hazard factor for the offset printing of a non E.coli being and for antibiotic opposition [ 43 ] .\r\nDiabetes ha s a considerable public wellness impact on the hazard for and forecast of enterobacterial bacteriemia acquired in the community [ 45 ] .\r\nScreening for or intervention for ASB is non indicated in adult females with diabetes and intervention with antibiotics did non detain nor hang the frequence of diagnostic UTI untill 3years of follow up [ 10 ] .\r\nThe clinical significance and direction of ASB differs harmonizing to different groups of patients as listed below [ 36 ]Indications for the intervention of patients with symptomless bacteriuriaDefinitive\r\n mathematical\r\nNot indicated\r\nPregnancy\r\nDiabetess mellitus\r\nelderly\r\nBefore an trespassing(a) GU process\r\nShort- term\r\nIndwelling catheterisation\r\nintermittent catheterisation\r\nSchool misss and premenopausal adult females\r\nChildren with reflux\r\n nephritic graft\r\nLong term indwelling catheter\r\nPatients with moved(p) urinary piece of land\r\nIn most of the old surveies E.coli was the most prevailing micr o-organism and klebsiella the 2nd most common [ 12 ] .\r\nAnalyzing the diabetic adult females with ASB showed that respective(a) E.coli strains are capable to be colonized in piss. Perennial infections were common chiefly after discussion ASB most often with a new E.coli strain [ 14 ] .\r\nIn patients who had frequent E.coli causation ASB, repeated intervention did non decide the vesica infection [ 14 ] .\r\nWhen compared to non diabetics ASB is more prevailing among females with type 2 diabetics in Sagamu, Nigeria [ 35 ] .\r\nWomans with ASB had a significantly higher prospect of developing a diagnostic UTI than not bacteriuric adult females [ 41 ]\r\nThere is an increased susceptibleness to urinary piece of land infections in female diabetics above the age of 50, and diabetes wishly in association with ripening, accentuates factors which cede the constitution of infection in non diabetic individuals instead than specially predisposing the kidney to infection [ 37 ] .\r\nGu idelines published by the IDSA in 2005 province that there is no measured benefit in testing or use ASB in the undermentioned patients: diabetic patients, premenopausal adult females who are non pregnant, older patients populating in the community and in the long term attention installations, and with spinal electric cord hurt patients or patients with indwelling vesica catheters [ 31 ] .\r\nScreening and handling is appropriate for adult females during gestation period and for patients who have a positive urine civilization consequence prior to surgical use of the urinary piece of land to avoid precipitating sepsis [ 31 ] .\r\nIn the past diabetes mellitus was regarded as a place in which ASB predisposed to renal papillose gangrene and nephritic inadequacy but recent retro and prospective surveies indicate that does non transport a nephritic hazard. Therefore the possible benefit from antibacterial intervention of ASB is dubious. However we emphasize that one time diagnostic urinary piece of land infection is present, it tends to incite a more aggressive clinical relegate in the diabetic patient [ 40 ] .\r\nFrom all the surveies, past attacks to direction differed between U.S and European doctors. In the U.S. , intervention of bacteriuria was recommended whereas in Europe, bacteriuria is non treated. Even if diabetic adult females with symptomless bacteriuria are at hazard for diagnostic urinary infection, the overall cost benefit of testing and handling big Numberss of symptomless diabetic adult females at frequent intervals was in the remove to be evaluated. The inquiries were complex and broad -ranging. There was a demand to construct the current clinical observations and prevalence studies to take a shit a foundation of cognition that is sufficient for developing rational and appropriate attack for caring for diabetic patient who has a urinary infection [ 3 ] . Long term follow up surveies forget demo whether ASB becomes diagnostic and affects nephritic map in diabetic patients and whether intervention of ASB is warranted [ 4 ] .\r\nRecently [ IDSA ] Infectitious disorder Society of America came out with a guidelines in the twelvemonth 2005 for diabetic adult females follows asDiabetic WomansMany prospective and cohort surveies done in diabetic adult females for ASB which was followed up for 18 months to 14years of showed no differences in rates of occurence diagnostic urinary infection, patterned salary increase to diabetic complications.There was no hold, lessening in urinary infections nor the no of hospitalizations in persons with bacteriuria after 3 old ages of follow up was clearly proved by a randomized, controlled test for bacteriuria reported after a upper intend of 3 old ages of follow-up. There was no quickening or patterned advance of diabetic complications like nephropathy etc. , in bacteriuric patients who did non have antimicrobic therapy. However, diabetic adult females who received antimicrobic ther apy had significantly more inauspicious antimicrobic effects. Thus go along testing and handling symptomless bacteriuria in diabetic adult females neer showed any benefits and there was even grounds of some injury ascribable antibiotic use.Recommendatio:Screening and intervention of symptomless bacteriuria in diabetic adult females is non indicated ( A-I ) .\r\nThe guidelines besides mention that antimicrobic therapy is often unsuccessful in eliminating the micro-organisms and may, in fact, consequence in occurence of immune micro-organisms, such as reach out spectrum ?-lactamase immune bacteriums, vancomycin †immune enterococci, and other multidrug-resistant bacteriums. In add-on, intervention of patients will subject them to the hazard of an allergic reaction, diarrhea, and other inauspicious reactions ensuing from usage of the antimicrobic drug. Finally, clostridia difficile infection may develop, because the intestine vegetation is altered when handling ASB [ 31 ] .\r\ nEndothelial disfunction, oxidative emphasis, and the increased formation of advanced terminal merchandises, lower urinary cytokine concentration and hence decreased urinary leucocyte Numberss compared with nondiabetic adult females may play a function in the evolution of diabetic complications [ 4 ] .\r\nDefective polymorphonuclear leucocyte maps [ opsonization, chemotaxis, phagocytosis and putting to death ] are possible conducive factors. Changes of bacterial shackle to uroepithelial cells, partially explained by alterations of the chemical science and concentration of Tamm-Horsfall protein besides promote urinary †piece of land infection [ 24 ] .\r\nThe vesica disfunction due to diabetic neuropathy taking to impaired vesica exclusion could play a function in the prevalence of ASB among adult females with diabetes and in the natural history of UTI [ 8,28 ] .\r\nclinical tests covering with the intervention of symptomless bacteriuria in diabetes are limited. The undermenti oned decisions can be made from these tests.\r\n everyday reinfections occur instead than backslidings.\r\nLong term suppressive therapy is effectual, nevertheless when discontinued, perennial infections occur comparatively quickly.\r\n fewer patients sustain a permanent remittal from bacteriuria.\r\n act obliteration of bacteriuria in patients with anatomic abnormalcies may be ineffectual.\r\nTherefore, there are no benefits in continued showing and handling diabetic persons with symptomless bacteriuria and as there is possibility of some injury with antibiotic overusage.Restrictions:In this survey we couldnt step HbA1c for all the patients as it was non executable and so couldnt assess the relationship between glucose degrees and symptomless bacteriuria.\r\nWe besides have no prospect whether there would be any opportunity of development of complications in the persons diagnosed with symptomless bacteriuria as this is non a follow up survey. Hence measuring of HbA1c degrees and a follow up of these civilization positive patients would give a better apprehension in the relationship between glucose degrees and asmptomatic bacteriuria and the presence or absence of complications in civilization positive patients.SummaryThere is a high incidence of symptomless bacteruria in diabetes patients, chiefly in females than males in this survey. Therefore, there are 2 subjects to inquiry, whether symptomless bacteriuria is associated with inauspicious results. ? , whether the intercessions of showing and antimicrobic intervention better these results? The inquiries whether they develop complications or non and whether antibiotic therapy is needed or non necessitate to be assessed by farther follow up surveies. However latest guidelines suggest that antimicrobic therapy did non detain nor diminish the frequence of diagnostic urinary infection, nor did it diminish the figure of hospitalizations due to urinary infections nor it prevented the acceleration of patterned adva nce of diabetic complications, therefore periodic proving for symptomless bacteriuria is non recommended for individuals with diabetes mellitus.DecisionBased on the consequences and the methodological analysis employed, we have concluded that:\r\n gritty incidence of symptomless bacteriuria has been observed in both diabetic males and females.\r\nHigh incidence of symptomless bacteriuria occur in both diabetes mellitus on insulin and unwritten hypoglycemic agents.\r\nCausative beings in diabetic and non diabetic symptomless bacteriuria are similar. E.coli is the commonest being.\r\nMost of the symptomless bacteriuria instances occurred in the age group of 41 to 60 old ages.\r\nAsymptomatic bacteriuria occur inspite of good glycemic control.\r\n. Preventive steps for diabetic patients include increased surveillance and turning by of well-known hazard factors for urinary piece of land infections.\r\nAsymptomatic bacteriuria can be present even in freshly diagnosed diabetic patients.\ r\nMost of the being are sensitive to nitrofurantoin. Some are sensitive to aminoglycosides, fluroquinolones.\r\nSome beings are merely sensitive to drawn-out spectrum ?-lactam antibiotics.\r\nPeriodic proving for symptomless bacteriuria is non recommended for individuals with diabetes mellitus as per latest guidelines.AbstractionAim: To crumble the incidence of symptomless bacteruria between diabetics and non diabetics, the common beings and their antibiotic sensitiveness\r\nMethods: A sum of 100 diabetic patients and 50 non diabetic controls without any history of urinary piece of land infection and catheterization was enrolled in this survey\r\nConsequences: The incidence of ASB was 39 in diabetic and 3 in control with the significance of P & A ; lt ; 0.001. Diabetic patients have 11.34 times higher hazard in developing symptomless bacteriuria than non diabetics.\r\nDecision: The incidence of ASB is significantly increased in diabetic patients as compared to non diabetic co ntrols.A larger survey with a longer follow-up is needed to turn to the issue of handling such patients who are symptomless\r\n'