SGLT2 Inhibitors and Genital Infections: A Hospital-Based Prospective study in a Tertiary Care Setting

Background “Type 2 diabetes mellitus (T2DM) is a long-term metabolic condition linked to a higher risk of infections”. Sodium-glucose cotransporter-2 (SGLT2) inhibitors, an antihyperglycemic drug class, have demonstrated efficacy in glycemic control and cardiovascular benefits. However, their use has been linked to an increased incidence of genital infections due to enhanced glucosuria. Purpose of the study: To assess the incidence of genital infections in patients using SGLT2 inhibitors. Methods A prospective observational study was carried out in patients on SGLT2 inhibitors, either as monotherapy or combination therapy, were included. Data on demographic characteristics, incidence of genital infections, symptoms, and associated factors were collected. IBM SPSS version 20 was used to carry out statistical analysis, with chi-square and logistic regression tests applied to evaluate associations. Results Among 200 patients (60% male, 40% female), 33% developed genital infections, with a greater frequency in females (36.25%) in contrast to males (30.8%). The most prescribed SGLT2 inhibitor was dapagliflozin (98.5%). Common symptoms included itching (58.3% in males, 41.7% in females), burning sensation (63% in males, 37% in females), and pain during urination (57.9% in males, 42.1% in females). Vaginal discharge was exclusive to females (p = 0.001), while abdominal pain was significantly more common in males (p = 0.005). No significant association was found between infection incidence and demographic factors. Conclusion Genital infections are a notable adverse effect of SGLT2 inhibitors, with a slightly higher risk in females. Patient education on hygiene and early symptom recognition is crucial in mitigating infection risk.