Impaired tolerance for glucose in women with recurrent vaginal candidiasis

OBJECTIVE: The purpose of this study was determine whether nondiabetic women with recurrent vaginal candidiasis have an impaired glucose metabolism. STUDY DESIGN: A case-control study of 62 otherwise healthy women who were attending a vaginitis clinic 3 times a year for symptoms of Candida vaginitis, positive microscopy, and at least one positive Candida culture and of 32 Candida-negative control subjects, all of whom were undergoing standardized oral glucose tolerance testing. RESULTS: Women with recurrent bacterial vaginal infections did not differ from women without infections, so both groups comprised the control group. Women with recurrent vaginal candidiasis had a greater mean body mass index than the control subjects (23.5 vs 21.4, P = .001). They had no more incidences of overt or preclinical diabetes mellitus than the control subjects (6/62 vs 0/32 incidents), but a greater proportion of them had at least one glucose concentration above the 95th percentile (36% vs 12%, P = .016). Glucose concentrations were higher in recurrent vaginal candidiasis cases than in control subjects at 0 (89 vs 85 mg/dL, P = .049), 30 (139 vs 126 mg/dL, P = .05), and 60 minutes (123 vs 102 mg/dL, P = .009) after the intake of 75 g of glucose. Fasting concentration of glycosylated hemoglobin was 25% higher in women with recurrent vaginal candidiasis (5 vs 4 g/dL, P = 0006), even after correction for body mass index. Compared with control subjects, ingestion of 75 g of glucose led to a 15% increase of serum glucose levels in women with recurrent vaginal candidiasis (P = .01). As expected, most of these differences were largely mediated by an increased body mass index. CONCLUSION: The tolerance to glucose in nondiabetic women with recurrent vaginal candidiasis is discretely impaired. Glucose tolerance testing is of value in women with recurrent vaginal candidiasis, but the interpretation of the obtained values should not be limited to the diagnosis of preclinical diabetes mellitus.