Scairati Roberta, Auriemma Renata S, Del Vecchio Guendalina, Di Meglio Sara, Pirchio Rosa, Graziadio Chiara, Pivonello Rosario, Colao Annamaria
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Università Federico II di Napoli, 80131 Naples, Italy.
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Università Federico II di Napoli, 80131 Naples, Italy.
Maturitas. 2025 Mar;194:108210. doi: 10.1016/j.maturitas.2025.108210. Epub 2025 Jan 30.
Diabetes mellitus is a chronic disease and a public health challenge worldwide, associated with numerous complications, including genitourinary infections and sexual dysfunction in women, particularly in menopause. The vaginal microbiome, which comprises beneficial and pathogenic bacteria, their genomes, and the surrounding environment, plays a crucial role in maintaining genitourinary health. Chronic hyperglycemia disrupts immune functions, exacerbates oxidative stress, and alters the vaginal microbiome, increasing the risk of genitourinary infections. Recent advances in microbial analysis, including 16S rRNA sequencing, have provided insights into the complex composition of the vaginal microbiome and its dysbiosis in diabetes mellitus. Some glucose-lowering drugs, such as sodium-glucose cotransporter 2 inhibitors, may increase the risk of genitourinary infections. Additionally, psychological distress, hormonal imbalances, and diabetes-related genitourinary symptoms contribute to sexual dysfunction in diabetic women. Healthcare for diabetic women requires a multidisciplinary approach, including not only glycemic control but also vaginal and sexual health assessment. A holistic approach is essential to advance personalized strategies, including medications and psychological support.
糖尿病是一种慢性疾病，也是全球范围内的公共卫生挑战，它与多种并发症相关，包括女性的泌尿生殖系统感染和性功能障碍，尤其是在更年期。阴道微生物群由有益菌和致病菌、它们的基因组以及周围环境组成，在维持泌尿生殖系统健康方面起着至关重要的作用。慢性高血糖会破坏免疫功能，加剧氧化应激，并改变阴道微生物群，增加泌尿生殖系统感染的风险。包括16S rRNA测序在内的微生物分析的最新进展，为了解糖尿病患者阴道微生物群的复杂组成及其失调情况提供了线索。一些降糖药物，如钠-葡萄糖协同转运蛋白2抑制剂，可能会增加泌尿生殖系统感染的风险。此外，心理困扰、激素失衡以及糖尿病相关的泌尿生殖系统症状会导致糖尿病女性出现性功能障碍。糖尿病女性的医疗保健需要多学科方法，不仅包括血糖控制，还包括阴道和性健康评估。采取整体方法对于推进个性化策略（包括药物治疗和心理支持）至关重要。
