Incidence and factors associated with genitourinary infections among Type 2 diabetes patients on SGLT2 Inhibitors: A single retrospective cohort study

Abstract

AimsTo determine the incidence and factors associated with genitourinary infection among patients with type 2 diabetes on SGLT2 inhibitors. MethodsThis was a retrospective cohort study that included 253 patients with type 2 diabetes who were on SGLT2 inhibitors from January 1, 2014 to June 30, 2019. Multiple logistic regression analysis was used to determine the factors associated with genitourinary infections. Results3 and 6-month incidences of genitourinary infections were 2.37% and 21.78%, respectively. Factors associated with genitourinary infections include HbA1c levels of ≥7.0 to <8.0% (OR=3.45; p=0.001), ≥8.0 to <9.0% (OR=8.56; p<0.0001), ≥9.0% (OR=11.45; p<0.0001), and concomitant sulfonylurea (SUR) (OR=4.13; p<0.001), and insulin (OR= 3.81; p<0.001) use. These factors were also associated with genital infection alone, in addition to overweight/obese BMI (OR=2.42; p=0.039) and diabetes duration of >10 years (OR=1.98; p=0.026). Factors associated with UTI alone were Hba1c levels of ≥8.0 to <9.0%, (OR=3.18; p=0.002) and ≥9.0% (OR=2.48; p=0.008) and eGFR of 30–60 ml/min (OR=2.94; p=0.003) ConclusionGenitourinary infection is common among patients on SGLT2 inhibitors within 6 months of treatment. Factors associated with genitourinary infections vary by gender and include HbA1c of ≥7.0%, and concomitant insulin and/or SUR use . Same factors were linked with genital infection alone, along with diabetes duration of >10 years and overweight/obese BMI. Factors associated with UTI alone include elevated Hba1c and eGFR of <60 ml/min.