Pathogenesis and Clinical Management of Vulvovaginal Candidiasis in Mexican Diabetic Patients: A Literature Review

Abstract

Vulvovaginal candidiasis (VVC) is a common fungal infection among women, with a significant subset experiencing recurrent or complicated episodes, particularly those with type 2 diabetes mellitus (T2DM). The interplay between hyperglycemia, immune dysregulation, and alterations in the vaginal microbiota creates a favorable environment for fungal persistence. Mexican women with T2DM often face more frequent and severe episodes, sometimes involving Candida spp. that are less responsive to standard treatments. This review examines the pathophysiological mechanisms, clinical presentation, antifungal resistance patterns, and therapeutic considerations relevant to the management of VVC in diabetic patients in Mexico. Emphasis is placed on tailored diagnostic approaches, including species-level identification through CHROMagar and MALDI-TOF, susceptibility-guided treatment, and the emerging role of next-generation antifungals such as oteseconazole. Addressing these challenges requires an integrated strategy that combines clinical vigilance with innovative diagnostic tools, evolving therapeutic options, and patient-centered education.