Effects of sodium glucose co-transporter 2 inhibitors on genital infections in female patients with type 2 diabetes mellitus– Real world data analysis

Aims: Sodium glucose co-transporter 2 (SGLT2) inhibitors are associated with increased risk of genital infections. We aimed to assess incidence and risk factors associated with genital infections among female patients with type 2 diabetes mellitus (T2DM) treated with SGLT2 inhibitors. Methods: We retrieved data on adult female patients with T2DM who initiated treatment with empagliflozin or dapagliflozin during March 2015–March 2018, in a large Israeli health maintenance organization (HMO). Genital infections were identified by diagnosis codes or relevant dispensed prescriptions. The proportion of days covered with SGLT2 inhibitors (SGLT2i–PDC) was measured. Univariate and multivariate analyses were performed to identify risk factors. Results: Of 1542/6153 patients, 25.1% had events of genital infections during a mean of 2.3 years. The adjusted hazard ratio (HR) was 4.25 for the highest versus lowest SGLT2i–PDC group. Younger age, history of genital infection, and estrogen therapy were associated with increased risk of genital infections. Chronic Kidney Disease and DPP4 inhibitor therapy at baseline were associated with lower risk of genital infections. Conclusions: Potential risk factors for genital infections were identified in women initiating SGLT2 inhibitors.