Risk of genital and urinary tract infections associated with SGLT‐2 inhibitors as an add‐on therapy to metformin in patients with type 2 diabetes mellitus: A retrospective cohort study in Korea

Abstract

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The Effects of Sodium-Glucose Cotransporter 2-Inhibitors on Steatosis and Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease or Steatohepatitis and Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials

“…One of the most acknowledged side effects when using SGLT-2i therapy is genitourinary infection [ 55 ]. Nevertheless, a recent Korean study demonstrated that genital and urinary tract infections appear to be two- to three-fold more frequent in females and patients over 60 years old [ 56 ], emphasizing the need for the rigorous monitoring of these categories.…”

Case 11: A 31-Year-Old Woman With Abdominal Pain

“…According to a previous study using Korean claims data, the use of SGLT2 inhibitors significantly increased genital and urinary tract infections, and these side effects were reported to occur more commonly in older patients and in females. 7 Therefore, it is necessary to be cautious in prescribing drugs of the SGLT2 inhibitor class to elderly women and in cases with a history of previous genitourinary infection.…”

Incident infection risks depending on oral antidiabetic exposure in insulin-treated type 2 diabetes patients

“…Diabetes itself is a well-known risk factor for infections as high blood glucose, compromised immune systems, and comorbid conditions can predispose patients to infectious disorders 9 – 11 . Safety signals have been detected thus far primarily with two major oral antidiabetic classes, DPP-4 inhibitors and SGLT-2 inhibitors, in terms of their potential to increase the risk of respiratory and urogenital infections, respectively 5 – 7 , 20 – 23 . To the best of our knowledge, this is the first study that defined the study patients as only those with advanced T2DM already on insulin treatment and investigated the effects of DPP-4 inhibitors and SGLT-2 inhibitors on infectious disease risks as compared to metformin effects in these patient populations.…”

“…These patient populations are susceptible to adverse health outcomes due to life-long exposure to hypoglycemic therapy and the attributes of T2DM itself that typically progresses to various metabolic dysfunctions 4 . Recently, it has been speculated in a series of studies that certain glucose-lowering agents, particularly dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium glucose cotransporter-2 (SGLT-2) inhibitors, might be associated with increased risk of infectious diseases 5 – 7 . Given that the prescription volume of the two antidiabetic classes is steadily on the rise 8 , a potential link between their use and infection risks, albeit still controversial, may well leave healthcare professionals worldwide uncertain about optimal glycemic control regimens for T2DM patients who are already predisposed to infections due to diabetes-associated impaired immune responses 9 – 11 .…”