Sodium-glucose cotransporter-2 inhibitors and genital and urinary tract infections in type 2 diabetes

Postgrad Med. 2016 May;128(4):409-17. doi: 10.1080/00325481.2016.1167570. Epub 2016 Apr 4.

Abstract

Coincident with the high and increasing worldwide prevalence of type 2 diabetes (T2D), a growing armamentarium of antidiabetes medications has been introduced to target different organ systems that play a role in the pathophysiology of T2D. Among these, the sodium-glucose cotransporter-2 (SGLT-2) inhibitors were introduced in the United States in 2013 as a new treatment option to address the hyperglycemia associated with T2D. SGLT-2 inhibitors decrease renal glucose reabsorption, resulting in glucosuria, alleviation of hyperglycemia, and modest weight loss and are associated with a low risk of hypoglycemia. The SGLT-2 inhibitors have been linked to an increased incidence of genital mycotic infections and, to a lesser extent, urinary tract infections, which may limit their utility in some patients. This review examines the prevalence, recurrence rates, treatment options, and responses to treatment of genital and urinary tract infections in patients with T2D receiving SGLT-2 inhibitors, with the aim of guiding clinicians in the most effective use of these agents for the treatment of hyperglycemia.

Keywords: Canagliflozin; dapagliflozin; empagliflozin; genital mycotic infection; sodium-glucose cotransporter-2 inhibitor; type 2 diabetes; urinary tract infection.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Glycosuria / chemically induced
  • Glycosuria / complications
  • Humans
  • Hypoglycemic Agents / adverse effects*
  • Prevalence
  • Recurrence
  • Reproductive Tract Infections / chemically induced
  • Reproductive Tract Infections / drug therapy
  • Reproductive Tract Infections / epidemiology*
  • Sodium-Glucose Transporter 2 Inhibitors*
  • Urinary Tract Infections / chemically induced
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology*

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors