Drug-induced normoglycemic candidal balanoposthitis: A case series

One therapeutic option to manage hyperglycemia is to increase renal glucose excretion by inhibiting sodium-glucose cotransporter-2 (SGLT2) glucose transport proteins. SGLT2 inhibitors (SGLT2i) represent a novel class of oral antidiabetic drugs which are associated with drug-induced glucosuria which can be associated with candidial balanoposthitis and genitourinary infections. Our report includes 10 patients. Their glycated hemoglobin (HbA1c) ranged between 7 and 10 before treatment with SGLT2i. They had one or more episodes of candidal balanoposthitis due to uncontrolled diabetes mellitus. 3 patients were on dapagliflozin 5 mg and 7 were on empagliflozin 10 mg. Their HbA1c after SGLT2i ranged from 5 to 5.6. No adverse effects like urinary tract infections were noted. All ten of them had recurrent candidal balanoposthitis and presumed that their sugar levels were under control. The anticipated association of SGLT2i and increased risk of genital infection is a major cause of concern for diabetologists.