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. 2024 Dec 16;16(12):e75798.
doi: 10.7759/cureus.75798. eCollection 2024 Dec.

Tolerability of Sodium-Glucose Co-transporter 2 Inhibitors in Patients With Type 2 Diabetes Mellitus: A Retrospective Cohort Study

Suhaib Radi  1   2   3 , Maher Almutairi  4   1 , Abdullah S Alghamdi  4   1 , Mustafa Alzahrani  4   1 , Siraj Alghamdi  4   1 , Nawwaf Almalky  1   4 , Bassam Alharbi  1   4 , Talal M Altuwaylie  5 , Fawziah Marwani  5 , Wafa Saber  5
Affiliations

Tolerability of Sodium-Glucose Co-transporter 2 Inhibitors in Patients With Type 2 Diabetes Mellitus: A Retrospective Cohort Study

Suhaib Radi et al. Cureus. .

Abstract

Background Sodium-glucose co-transporter 2 (SGLT2) inhibitors are an emerging treatment for type 2 diabetes mellitus (T2DM). The effect and tolerability of SGLT2 inhibitors in patients with T2DM, especially related risk factors and susceptible populations, are an area of ongoing research. Aim The aim of this study was to evaluate the tolerability of SGLT2 inhibitors, particularly the risk associated with urogenital infection, in patients with T2DM. Methods This retrospective cohort study included 275 participants (median age: 64 years). Electronic medical records of patients with T2DM who underwent treatment with approved SGLT2 inhibitors between January 2020 and December 2022 at our institute were reviewed. Multiple variables were used to assess the tolerability of SGLT2 inhibitors and factors associated with genitourinary infections. Results The incidence of genitourinary infections was 13.1% among patients with T2DM taking SGLT2 inhibitors, which was lower than the reported national and global incidences of urinary tract infections (UTIs) among patients with diabetes. Patients with a history of UTIs were more likely to develop recurrent infections (hazard ratio [HR], 3.32; 95% confidence interval [CI]: 1.56, 7.09). A higher pretreatment glomerular filtration rate was associated with a lower risk of UTIs (HR, 0.98; 95% CI: 0.97, 0.99). Conclusions SGLT2 inhibitor administration in patients with T2DM does not significantly increase the risk of UTIs compared with the reported national and global rates of UTIs among patients with diabetes. Variable hygiene practices among the Muslim community may be a possible explanation for the observed differences in the rates of UTIs.

Keywords: diabetes mellitus; genital infections; sodium-glucose co-transporter 2 inhibitors; type 2 diabetes; urinary tract infection.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Committee of the King Abdullah Medical Research Center issued approval NRJ22J/009/01. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Kaplan–Meier curve for the development of urogenital infections associated with SGLT2 inhibitor
The curve displays the outcomes of the log-rank test, indicating notable sex differences in the likelihood of developing urinary tract infections associated with SGLT2 inhibitor use. Women exhibited a significantly higher probability of urinary tract infection development (p<0.05). The x-axis represents time in months. A p-value of <0.05 was considered statistically significant. SGLT2, sodium-glucose co-transporter 2
See this image and copyright information in PMC

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