Safety of SGLT2 Inhibitors and Urinary Tract Infections in Clinical Practice-A Cross-Sectional Study

Background and Objectives: Type 2 diabetes (T2DM) affects millions across the globe, generating a veritable public health issue through quality-of-life-reducing chronic complications, among which urinary tract infections are the most common. A shift in the disease managing paradigm from a glucose-centered view to a concept of cardio-reno-metabolic health has uniquely placed SGLT2 inhibitors as viable medication for the complex management of T2DM and its comorbidities. Some concerns have been raised over the increased likelihood of urinary tract infections (UTIs) associated with SGLT2 inhibitor use. The current study aims to evaluate the risk of developing urinary tract infections if patients with type 2 diabetes take SGLT2 inhibitors and determine those factors which make these patients more prone to develop this undesired complication. Materials and Methods: A cross-sectional, noninterventional evaluation of 328 patients with type 2 diabetes consecutively admitted to the Diabetes Clinic of "Pius Brinzeu" County Emergency Hospital in Timisoara, between January and February of 2024, was performed by examining medical charts and running statistical analyses using MedCalc version 22.26.0.0. Results: There was no statistical difference between patients taking SGLT2 inhibitors and those taking other glucose lowering medications when examining the presence of UTIs. Those patients with a higher HbA1c or BMI showed an increased predisposition to contracting UTI. The female gender was also associated with an increased likelihood of UTI. A further evaluation of the sublot of patients taking SGLT2 inhibitors revealed that not only higher BMI or HbA1c could be a predictor for the likelihood of developing UTI, but also a longer duration of T2DM was a predisposing factor. Conclusions: The use of SGLT2 inhibitors did not increase the likelihood of developing a urinary tract infection in this patient population.