- In women with type 2 diabetes (T2D) using sodium glucose co-transporter 2 inhibitors (SGLT2is), genital infection (GI) risk is greater with younger age, gastrointestinal history, and estrogen therapy.
- Risk is lower with chronic kidney disease (CKD) and baseline dipeptidyl peptidase-4 inhibitor (DPP4i) use.
Why this matters
- Both diabetes and SGLT2is increase GI risk, particularly among women.
- Data analyzed for 6153 adult women with T2D from an Israeli health maintenance organization during March 2015-March 2018.
- Funding: Marom.
- During mean 2.3 years of follow-up, 25.1% had GIs.
- Higher SGLT2i-proportion of days covered (SGLT2i-PDC) was associated with increased GI risk for SGLT2i-PDC ≥80% vs SGLT2i-PDC
- GI diagnosed >30 days postindex date:
- Adjusted (a)HR: 4.25 (P<.0001>
- GI risk increased by 15% for each 10% increase in SGLT2i-PDC:
- aHR: 1.015 (P<.001>
- Age ≤55 vs >70 years: 1.74 (P<.001>
- Prior GI history: 2.39 (P<.001>
- Recent oral contraceptive/hormone replacement therapy use: 1.37 (P=.002).
- CKD: 0.84 (P=.001); and
- Baseline DPP4i use: 0.89 (P=.019).
- Possible selection bias, residual confounding.
- Milder GIs possibly excluded.
- No data on antibiotic use, precise SGLT2i exposure timing.
- Canagliflozin is unavailable in Israel.