Impact of sodium-glucose cotransporter-2 inhibitors-induced glucosuria in the incidence of urogenital infection on postmenopausal women with diabetes

ABSTRACT

Background

Type 2 diabetes mellitus (T2DM) in postmenopausal women is associated with a high incidence of urogenital infections, which negatively impact the quality of life and increase morbidity, mortality, and health-care costs. Glucosuria is a known risk factor for these infections; therefore, it is of interest to determine if increased glucosuria secondary to sodium-glucose cotransporter-2 inhibitors (SGLT2in) impacts the incidence and severity of urogenital infections in postmenopausal women with T2DM.

Methods

The study was conducted at Gaffrée Guinle University Hospital on two groups of postmenopausal women with T2DM: with and without SGLT2in therapy (n = 80 in each group). Medical records and laboratory parameters (urinary dipstick test and culture; blood glucose, glycosylated hemoglobin, and creatinine; cervical cytologic study) of all subjects were carefully assessed at baseline and thrice during the 12-month study period.

Results

We observed a significant incidence of vulvovaginitis (relative risk [RR], 2.37; 95% confidence interval [CI], 1.10–5.10; P = 0.03) and asymptomatic bacteriuria (RR, 2.47; 95% CI, 1.09–5.60; P = 0.03), but not of urinary tract infections (RR, 2.08; 95% CI, 0.74–5.81; P = 0.16), secondary to SGLT2in therapy. Genital infection was severe enough to warrant treatment discontinuation in 57.89% of patients in group 1. All urinary tract infections were of mild intensity with a good response to antibiotic therapy.

Conclusion

Glucosuria induced by SGLT2in therapy may lead to a high incidence of urogenital infections in postmenopausal women with T2DM and can be considered a risk factor for these infections.

KEYWORDS:

• Type 2 diabetes mellitus
• sodium-glucose cotransporter 2 inhibitor
• urogenital infection
• urinary tract infection
• asymptomatic bacteriuria

Contribution statement

All authors were involved in the process of collecting data, writing, and reviewing of the manuscript. The manuscript has been read and approved by all the authors.

Declaration of interest

The paper and opinions’ content expressed with are those of the authors, and they decided to submit the manuscript for publication.

The authors report no conflicts of interest.

Reviewer disclosure

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This research received no grant from any funding agency in the public, commercial, or not-for-profit sectors.