The Impact of Glycemic Control on Sodium-Glucose Co-Transporter 2 Inhibitor-Associated Genitourinary Infections.

IF 2.3 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Annals of Pharmacotherapy Pub Date : 2024-10-01 Epub Date: 2024-02-06 DOI:10.1177/10600280241227973
Anthony Gerber, Victoria Rupp, Natalia Ryabenkova, Nataliya Mikhelzon
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引用次数: 0

Abstract

Background: Patients with type 2 diabetes (T2D) are at an increased risk of genital urinary (GU) infections, with the risk increasing with higher A1Cs. Given the broad adoption of sodium-glucose co-transporter 2 inhibitors (SGLT2is) in patients with T2D, both providers and patients need to be aware of common adverse effects associated with these medications, specifically GU infections. However trials involving SGLT2is looked at patients with an average A1C of less than 9%, and thus, the incidence of GU infections may not truly reflect the general diabetic population.

Objective: The purpose of this study is to assess the association between GU infections in patients started on SGLT2is and A1C levels.

Methods: A retrospective study was conducted on patients seen in an adult, primary care clinic, at New York City Health and Hospitals, South Brooklyn Health. Men and nonpregnant, nonlactating women >18 years old with a diagnosis of T2D who were initiated on an SGLT2i between January 2018 and January 2023 were included in the analysis. The primary endpoint is to compare the risk of GU infections in patients with T2D who were started on SGLT2is, regardless of dose, with hemoglobin A1C of >9% to those with hemoglobin A1C <9% at baseline.

Results: Three hundred and twenty-eight patients were eligible based on specified inclusion and exclusion criteria. Overall, there was a statistically significant difference in the number of GU infections that occurred in patients with a baseline A1C >9% compared with those with an A1C <9% (95% confidence interval [CI] = 1.05-2.88; P = 0.041).

Conclusions and relevance: Type 2 diabetes patients initiated on SGLT2is may experience an increased risk of GU infection, especially in those patients with an A1C of 9% or greater. Further research is necessary to validate and expand upon these findings.

血糖控制对钠-葡萄糖协同转运体 2 抑制剂相关泌尿生殖系统感染的影响。
背景:2型糖尿病(T2D)患者发生生殖器泌尿系统(GU)感染的风险增加,且风险随着A1C的升高而增加。鉴于钠-葡萄糖协同转运体 2 抑制剂(SGLT2is)被广泛应用于 T2D 患者,医疗服务提供者和患者都需要了解与这些药物相关的常见不良反应,特别是生殖器泌尿系统感染。然而,涉及 SGLT2is 的试验以平均 A1C 低于 9% 的患者为研究对象,因此 GU 感染的发生率可能无法真实反映普通糖尿病患者的情况:本研究的目的是评估开始服用 SGLT2is 的患者发生 GU 感染与 A1C 水平之间的关系:这项回顾性研究的对象是在纽约市健康与医院南布鲁克林健康中心的成人初级保健诊所就诊的患者。2018年1月至2023年1月期间开始使用SGLT2i的诊断为T2D的男性和年龄大于18岁的非怀孕、非哺乳期女性被纳入分析范围。主要终点是比较血红蛋白A1C>9%的T2D患者与血红蛋白A1C结果>9%的患者开始服用SGLT2i(无论剂量大小)时发生GU感染的风险:根据规定的纳入和排除标准,328 名患者符合条件。总体而言,与 A1C P = 0.041 的患者相比,基线 A1C >9% 的患者发生 GU 感染的数量有显著统计学差异:开始服用 SGLT2is 的 2 型糖尿病患者发生 GU 感染的风险可能会增加,尤其是 A1C 为 9% 或以上的患者。有必要开展进一步的研究来验证和扩展这些发现。
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来源期刊
CiteScore
5.70
自引率
0.00%
发文量
166
审稿时长
3-8 weeks
期刊介绍: Annals of Pharmacotherapy (AOP) is a peer-reviewed journal that advances pharmacotherapy throughout the world by publishing high-quality research and review articles to achieve the most desired health outcomes.The articles provide cutting-edge information about the most efficient, safe and cost-effective pharmacotherapy for the treatment and prevention of various illnesses. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 14 days
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