# Elucidating the Nexus Between Urinary Tract Infection and Diabetes

> **NIH NIH R21** · TEXAS A&M AGRILIFE RESEARCH · 2022 · $227,250

## Abstract

Urinary tract infection (UTI) is among the most common bacterial infection encountered by millions of people
annually. UTI is a top reason for antibiotic use, which further compounds the crisis of antimicrobial resistance in
bacterial pathogens. Uropathogenic Escherichia coli (UPEC) is the predominant etiological agent of UTI.
Diabetes is a metabolic disease that significantly increases the propensity for development of UTI, and
dangerous complications of UTI. In the United States, ~4 in 10 people were either diabetic or prediabetic in
2018, and type 2 diabetes mellitus (T2DM) is the most common form of diabetes. Glucosuria (urinary glucose
excretion) in diabetics has been presumed to increase the incidence UTI. However, roles of glucose-fueled
bacterial growth in the urinary tract, changes in the host response to bacterial pathogens during UTI, and shifts
in the metabolite landscape of the urinary tract in diabetic hosts continue to remain poorly understood.
Mechanistic understanding of how diabetes increases the risk for UTI is critical to design effective intervention
strategies, and to develop novel approaches to monitor urinary tract health in diabetics. Significant increases in
bacterial burden in the urinary tract, and higher levels of bacteremia and systemic infection with UPEC during
UTI were observed in non-diabetic mice with gliflozin-induced glucosuria. Gliflozins are promising tools to probe
the role of glucosuria in the interaction between uropathogens and diabetic hosts. Specifically, this proposal will
investigate the effect of glucosuria and other urinary metabolites on the outcomes of UTI in diabetic and healthy
(control) hosts. The long-term research goal is to define the cellular and molecular determinants of health and
disease in the urinary tract. The central hypothesis for this study is that glucosuria is the primary determinant of
bacterial colonization in the diabetic urinary tract, and that diabetes-induced changes in urinary metabolites
promote bacterial UTI. This hypothesis will be tested in a mouse model of experimental UTI, and T2DM with the
following Aims: 1) Determine the impact of glucosuria on the outcomes of bacterial UTI in a mouse model of type
2 diabetes; and 2) Define the diabetic urinary metabolome, and its role in promoting UTI. This study is expected
to shed light on how glucose and other metabolites affect bacterial virulence and host response during UTI in
diabetic hosts. The substantial positive impact of this study will be elucidating the causal link between UTI and
diabetes. The proposed study is significant because these findings are anticipated to provide mechanistic
insights into factors that contribute to increased risk for UTI during diabetes. The proposed approach is innovative
because it integrates gliflozin-induced glucosuria with a mouse model of T2DM, and metabolome analysis to
address the nexus between UTI and diabetes. In summary, the proposed study is expected to confer a significant
pub...

## Key facts

- **NIH application ID:** 10527498
- **Project number:** 1R21AI166162-01A1
- **Recipient organization:** TEXAS A&M AGRILIFE RESEARCH
- **Principal Investigator:** Sargurunathan Subashchandrabose
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $227,250
- **Award type:** 1
- **Project period:** 2022-06-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10527498

## Citation

> US National Institutes of Health, RePORTER application 10527498, Elucidating the Nexus Between Urinary Tract Infection and Diabetes (1R21AI166162-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10527498. Licensed CC0.

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