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Genital Infections with Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients with Type 2 Diabetes Mellitus.
Indian J Endocrinol Metab 2018 Nov-Dec; 22(6):837-842IJ

Abstract

Diabetes is a metabolic disorder characterized by hyperglycemia and is associated with several comorbidities and complications. Genital infection is one such complication that is often associated with diabetes mellitus (DM). Even though abnormalities in immune system, high urine glucose, and bladder dysfunction are important contributors for the increased risk of genitourinary symptoms, yet the possible role of pharmacologically induced glucosuria cannot be completely overlooked in such patients. There are various classes of medications to control blood glucose levels. A new 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. Currently, canagliflozin, dapagliflozin, and empagliflozin are the three SGLT2i approved for therapy in Type 2 DM (T2DM). Safety studies with these three SGLT2i have reported events of mild-moderate genital infections in patients on SGLT2i therapy. However, most of the reported infections responded to standard treatment. Apart from SGLT2i, factors including personal hygiene, menopause, and circumcision might have a possible role in reported events of genital infections among T2DM patients on SGLT2i therapy. The present review identifies the occurrence of genital infections in diabetic patients on SGLT2i therapy, factors affecting the incidence of genital infections, and management strategies in patients with T2DM on SGLT2i therapy.

Authors+Show Affiliations

Department of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India.Department of Endocrinology, Bharti Research Institute of Diabetes, Bharti Hospital, Karnal, Haryana, India.Department of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India.Medical Affairs, AstraZeneca Pharma India Ltd., Bengaluru, Karnataka, India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30766827

Citation

Unnikrishnan, A G., et al. "Genital Infections With Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients With Type 2 Diabetes Mellitus." Indian Journal of Endocrinology and Metabolism, vol. 22, no. 6, 2018, pp. 837-842.
Unnikrishnan AG, Kalra S, Purandare V, et al. Genital Infections with Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients with Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018;22(6):837-842.
Unnikrishnan, A. G., Kalra, S., Purandare, V., & Vasnawala, H. (2018). Genital Infections with Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients with Type 2 Diabetes Mellitus. Indian Journal of Endocrinology and Metabolism, 22(6), pp. 837-842. doi:10.4103/ijem.IJEM_159_17.
Unnikrishnan AG, et al. Genital Infections With Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients With Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018;22(6):837-842. PubMed PMID: 30766827.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Genital Infections with Sodium Glucose Cotransporter-2 Inhibitors: Occurrence and Management in Patients with Type 2 Diabetes Mellitus. AU - Unnikrishnan,A G, AU - Kalra,Sanjay, AU - Purandare,Vedavati, AU - Vasnawala,Hardik, PY - 2019/2/16/entrez PY - 2019/2/16/pubmed PY - 2019/2/16/medline KW - Balanitis KW - SGLT2i KW - balanoposthitis KW - genital infection KW - glucosuria KW - vulvovaginal candidiasis SP - 837 EP - 842 JF - Indian journal of endocrinology and metabolism JO - Indian J Endocrinol Metab VL - 22 IS - 6 N2 - Diabetes is a metabolic disorder characterized by hyperglycemia and is associated with several comorbidities and complications. Genital infection is one such complication that is often associated with diabetes mellitus (DM). Even though abnormalities in immune system, high urine glucose, and bladder dysfunction are important contributors for the increased risk of genitourinary symptoms, yet the possible role of pharmacologically induced glucosuria cannot be completely overlooked in such patients. There are various classes of medications to control blood glucose levels. A new 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. Currently, canagliflozin, dapagliflozin, and empagliflozin are the three SGLT2i approved for therapy in Type 2 DM (T2DM). Safety studies with these three SGLT2i have reported events of mild-moderate genital infections in patients on SGLT2i therapy. However, most of the reported infections responded to standard treatment. Apart from SGLT2i, factors including personal hygiene, menopause, and circumcision might have a possible role in reported events of genital infections among T2DM patients on SGLT2i therapy. The present review identifies the occurrence of genital infections in diabetic patients on SGLT2i therapy, factors affecting the incidence of genital infections, and management strategies in patients with T2DM on SGLT2i therapy. SN - 2230-8210 UR - https://www.unboundmedicine.com/medline/citation/30766827/Genital_Infections_with_Sodium_Glucose_Cotransporter-2_Inhibitors:_Occurrence_and_Management_in_Patients_with_Type_2_Diabetes_Mellitus L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/30766827/ DB - PRIME DP - Unbound Medicine ER -