1. Impact of sodium-glucose cotransporter-2 inhibitors-induced glucosuria in the incidence of urogenital infection on postmenopausal women with diabetes.
- Author
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Marques LPJ, Mendonça NA, Müller L, André ACPD, Madeira EPQ, and Vieira LMSF
- Subjects
- Aged, Anti-Bacterial Agents therapeutic use, Bacteriuria etiology, Blood Glucose, Case-Control Studies, Creatinine blood, Female, Glycated Hemoglobin, Humans, Incidence, Longitudinal Studies, Middle Aged, Prospective Studies, Risk Factors, Severity of Illness Index, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Urinary Tract Infections drug therapy, Vulvovaginitis etiology, Diabetes Mellitus, Type 2 drug therapy, Glycosuria chemically induced, Glycosuria complications, Postmenopause, Sodium-Glucose Transporter 2 Inhibitors adverse effects, Urinary Tract Infections etiology
- Abstract
Background: Type 2 diabetes mellitus (T2DM) in postmenopausal women is associated with a high incidence of urogenital infections, which negatively impact the quality of life and increase morbidity, mortality, and health-care costs. Glucosuria is a known risk factor for these infections; therefore, it is of interest to determine if increased glucosuria secondary to sodium-glucose cotransporter-2 inhibitors (SGLT2in) impacts the incidence and severity of urogenital infections in postmenopausal women with T2DM., Methods: The study was conducted at Gaffrée Guinle University Hospital on two groups of postmenopausal women with T2DM: with and without SGLT2in therapy (n = 80 in each group). Medical records and laboratory parameters (urinary dipstick test and culture; blood glucose, glycosylated hemoglobin, and creatinine; cervical cytologic study) of all subjects were carefully assessed at baseline and thrice during the 12-month study period., Results: We observed a significant incidence of vulvovaginitis (relative risk [RR], 2.37; 95% confidence interval [CI], 1.10-5.10; P = 0.03) and asymptomatic bacteriuria (RR, 2.47; 95% CI, 1.09-5.60; P = 0.03), but not of urinary tract infections (RR, 2.08; 95% CI, 0.74-5.81; P = 0.16), secondary to SGLT2in therapy. Genital infection was severe enough to warrant treatment discontinuation in 57.89% of patients in group 1. All urinary tract infections were of mild intensity with a good response to antibiotic therapy., Conclusion: Glucosuria induced by SGLT2in therapy may lead to a high incidence of urogenital infections in postmenopausal women with T2DM and can be considered a risk factor for these infections.
- Published
- 2020
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