#VisualAbstract: Sodium–Glucose Cotransporter-2 Inhibitors and the Risk for Severe Urinary Tract Infections

1. No significant difference in severe UTIs was observed between patients starting SGLT-2 inhibitors for type 2 diabetes, compared to DPP-4 inhibitors or GLP-1 agonists.

Evidence Rating Level: 2 (Good)

Study Rundown: The sodium glucose cotransporter-2 (SGLT-2) inhibitors are a newer class of diabetic medications that act by inhibiting glucose reabsorption in the proximal tubule, thereby reducing serum glucose levels. Since SGLT-2 inhibitors increase the availability of glucose in the urinary tract, there is concern the mechanism might promote bacterial growth. Studies have suggested that SGLT-2 inhibitors increase the risk of mild and moderate urinary tract infections (UTIs); however, findings are currently conflicting. This study utilized two large databases of U.S. commercial claims. The primary aim was to assess whether the initiation of SLGT-2 inhibitor therapy was associated with increased risk for severe UTIs. Inclusion criterion consisted of patients with type 2 diabetes, ages 18 or older, and had initiated SGLT-2 use, versus DPP-4 inhibitors or GLP-1 agonists. The study found that SGLT-2 inhibitors were not associated with increased risk for severe UTI compared with other anti-diabetic medications.. One limitation of this study was that the patient cohort was restricted to those with commercial insurance; therefore, the study results may not be fully generalizable to other patient groups.

Click to read the study in Annals of Internal Medicine

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