Highlights
- •Women aged 50 years or over administered sodium-glucose co-transporter 2 (SGLT2) for type 2 diabetes mellitus were at higher risk of genital infection and urinary tract infection.
- •The highest risk of urinary tract infection and genital infection was observed 8–14 days and 15–28 days after initiating SGLT2 inhibitor therapy, respectively.
- •The monitoring of urogenital infections in women aged over 50 years, especially during the first month after starting SGLT2 inhibitors, is recommended.
Abstract
This study aimed to investigate the age- and sex-specific risk of urogenital infections
in patients with type 2 diabetes mellitus (T2DM) treated with sodium-glucose co-transporter
2 (SGLT2) inhibitors. A self-controlled case series was conducted using annual national
patient sample datasets from 2016 and 2017. Patients who were treated with SGLT2 inhibitors
and who received antimicrobials for urogenital infections were included in the study.
The incidence rate ratio (IRR) of urogenital infections during SGLT2 inhibitor exposure
were compared with those in the non-exposure period. A total of 2,949 patients were
included in the analysis, and 71.2% of the patients were women aged ≥ 50 years. Stratified
analysis by age and sex showed that only women ≥ 50 years showed a significant increase
in the risk of urinary tract infections (UTIs) (IRR 1.25, 95% CI 1.14–1.37) and genital
infections (IRR 1.44, 95% CI 1.28–1.62). The highest risk of UTI risk was observed
8–14 days after initiating SGLT2 inhibitor therapy (IRR 1.49, 95% CI 1.07–2.08), and
after 15–28 days for genital infections (IRR 2.11, 95% CI 1.66–2.67) in women ≥ 50.
SGLT2 inhibitors increase the risk of urogenital infections in T2DM patients, especially
in women aged ≥ 50 years. Monitoring of urogenital infections in women aged ≥ 50 years,
especially during the first month after starting SGLT2 inhibitors, is recommended.
Keywords
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Article info
Publication history
Published online: June 12, 2021
Accepted:
June 8,
2021
Received in revised form:
May 31,
2021
Received:
April 7,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
