Diabetes Meds May Cause UTIs and Genital Infections

Certain diabetes medications may be associated with a significantly higher risk of genital infections compared with placebo or other active treatments, according to a study published in Diabetes, Obesity and Metabolism.

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Urinary tract infections and genital infections occur frequently in patients with type 2 diabetes; however, it is unclear which drugs are the most likely to cause these conditions. Therefore, researchers led by Dandan Li, MSc, Capital Medical University (Beijing, China), performed a review to evaluate the effects of different sodium-glucose co-transporter 2 inhibitors (SGLT2) on the risk of UTIs and genital infections in patients with type 2 diabetes.

For the review, they searched PubMed, Embase, CENTRAL, and ClinicalTrials.gov from inception to October 9, 2016 to identify randomized controlled trials reporting the occurrence of UTIs and genital infections in patients with type 2 diabetes who were also treated with SGLT2 inhibitors. Pairwise and network meta-analyses were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). 

A total of 52 randomized controlled trials with 36,689 patients were identified and included in the analysis. Overall, 3 specific drugs, canagliflozin, dapagliflozin and empagliflozin, were associated with a higher risk of genital infections than placebo, with ORs ranging from 3.21 (95% CI 2.08-4.93) for dapagliflozin 2.5 mg to 5.23 (95% CI 3.86-7.09) for canagliflozin 300 mg.

However, only dapagliflozin was associated with significantly more UTIs than placebo. Additionally, the risk of UTIs and genital infections both seemed to have a dose-specific relationship for dapagliflozin only.

Therefore, the researchers concluded that canagliflozin, dapagliflozin and empagliflozin were associated with a significantly higher risk of genital infections compared with placebo and other active diabetes treatments, though only dapagliflozin had a relationship with UTIs and genital infections that was dose-specific.—Sean McGuire

Reference

Li D, Wang T, Shen S, Fang Z, Dong Y, Tang H. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2016.  doi: 10.1111/dom.12825.