Introduction:

Sodium-glucose co-transporter 2 inhibitor (iSGLT2) drugs are being increasingly used in type 2 diabetes mellitus (DM2), due to their benefit in chronic kidney disease and heart failure - frequent comorbidities in patients with DM2. Evidence has been found linking iSGLT2 usage to an increased risk of genital infections. Regarding iSGLT2’s association with urinary tract infections (UTI), the findings are inconsistent.

Aim:

Determine in a sample taken from a primary care center, to determine whether DM2 patients treated with iSGLT2 are at an increased risk of UTI and genital infections when compared to DM2 patients treated only with other antidiabetic drugs.

Methods:

A case-control study, of a population of DM2 patients from a primary care center in the north of Portugal. Records from the year 2021 of cystitis, pyelonephritis/pyelitis, balanitis, prostatitis, vaginitis, candidiasis, and trichomoniasis, of iSGLT2 medicated DM2 patients were compared to those without this treatment (group variable: case with iSGLT2 vs control without iSGLT2). Logistic regression models were utilized to derive the association between iSGLT2 usage and previously mentioned infections.

Results:

Final sample: 953 patients. The group iSGLT2 was protective of the outcome cystitis, with an OR=0.47 [0.24; 0.90]. After adjusting for potential confounding factors this association was no longer significant - OR=0.54 [0.27; 1.07]. There was no significant association found between iSGLT2 usage and pyelonephritis/pyelitis, balanitis, prostatitis, vaginitis, candidiasis, and trichomoniasis.

Conclusion:

The present study seems to favor iSGLT2 safety regarding urinary and genital infections that may limit the prescription of these drugs.

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