Diabetes, SGLT-2 Inhibitors, and Urinary Tract Infection: a Review

Curr Diab Rep. 2024 May;24(5):108-117. doi: 10.1007/s11892-024-01537-3. Epub 2024 Mar 1.

Abstract

Purpose of review: The aim of this review is to focus on epidemiology, pathogenesis, risk factors, management, and complications of UTI in people with diabetes as well as reviewing the association of SGLT-2 inhibitors with genitourinary infections.

Recent findings: Individuals diagnosed with T2DM are more prone to experiencing UTIs and recurrent UTIs compared to individuals without T2DM. T2DM is associated with an increased risk of any genitourinary infections (GUI), urinary tract infections (UTIs), and genital infections (GIs) across all age categories. SGLT2 inhibitors are a relatively new class of anti-hyperglycemic agents, and studies suggest that they are associated with an increased risk of genitourinary infections. The management of diabetes and lifestyle modifications with a patient-centric approach are the most recognized methods for preventing critical long-term complications including genitourinary manifestations of diabetes. The available data regarding the association of SGLT-2 inhibitors with genitourinary infections is more comprehensive compared to that with UTIs. Further research is needed to better understand the mechanisms underlining the association between SGLT-2 inhibitors and genital infections and UTIs.

Keywords: Asymptomatic bacteriuria; Candida vulvovaginal infection; Genitourinary infection; SGLT-2 inhibitors; Type 2 diabetes; UTI.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Risk Factors
  • Sodium-Glucose Transporter 2 Inhibitors* / adverse effects
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
  • Urinary Tract Infections* / drug therapy

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Hypoglycemic Agents