New Study Finds Low Risk of Urinary Tract Infections in Japanese Diabetic Patients Taking SGLT2 Inhibitors
The latest breakthrough in diabetes treatment comes in the form of SGLT2 inhibitors, which have shown promising results in lowering blood sugar levels. However, concerns regarding the risk of urinary tract infections have been raised due to the drug’s mechanism of action.
SGLT2 inhibitors prevent the reabsorption of glucose in the kidneys, resulting in its elimination through the urinary tract. As a consequence, some patients experienced urinary tract infections as a side effect. However, recent research conducted by the Yotsuya Medical Cube research team in Japan has debunked this concern.
The study focused on the relationship between SGLT2 inhibitors and urinary tract infections in a population of over 107,000 Japanese individuals aged 20 and above. Among them, approximately 1.6 million had diabetes and around 268,000 of these diabetic patients were taking SGLT2 inhibitors.
Comparing the risk of developing urinary tract infections between non-diabetic and diabetic patients, the study found that the risk was higher in male and female diabetic patients by 71% and 90% respectively. However, interestingly, in male diabetic patients, the risk was inversely related to the prescription of SGLT2 inhibitors.
Further analysis revealed that the use of SGLT2 inhibitors was inversely related to urinary tract infections in men under 39, in their 40s to 50s, and over 60. As for women, this inverse relationship was observed in those under 39, but not significantly relevant in those over 40 years old.
The research team suggested that the reason behind these findings could be attributed to appropriate prescription practices, where SGLT2 inhibitors were being prescribed to patients who were less prone to recurrent urinary tract infections.
Based on these results, the research team concluded that there is no evidence indicating that SGLT2 inhibitors increase the risk of urinary tract infections in Japanese diabetic patients, regardless of their gender or age.
However, they emphasized the need for large-scale research in diabetic patients with chronic heart failure and chronic kidney disease, as the indications for SGLT2 inhibitors continue to expand.
The most recently developed diabetes treatment is an SGLT2 (sodium-glucose cotransporter) inhibitor.
It has a mechanism to lower blood sugar by preventing the reabsorption of glucose in the kidneys, and because glucose is excreted through the urinary tract, one of the side effects of the drug was a urinary tract infection. However, recent research has shown that it does not increase the risk of urinary tract infections.
The Yotsuya Medical Cube research team in Japan reviewed the relationship between SGLT2 inhibitors and urinary tract infections in Japanese people aged 20 years or older and reported in the Endocrine Journal that the risk of urinary tract infections was low in young male and female diabetic patients.
The subject of this analysis is approximately 107,000 people (4,675,000 men) aged 20 or over. Among them, 1,666,000 people (978,000 men) had diabetes. Among them, about 268,000 diabetic patients (about 180,000 men) take SGLT2 inhibitors (6 such as dapagliflozin and empagliflozin).
As a result of comparing the risk (odds ratio) of developing a urinary tract infection by dividing them into non-diabetic and diabetic patients, it was found to be 71% (6.98% compared to 4.21%) and 90% (8.96% vs. 4.91%) was higher in male and female diabetic patients, respectively.
In addition, urinary tract infections in male diabetic patients were inversely related to the prescription of SGLT2 inhibitors, but there was no difference in women depending on whether they were taking SGLT2 inhibitors.
In the analysis by age, SGLT2 inhibitor prescribing was inversely related to men in those under 39, in their 40s to 50s, and over 60, while in women it was similar to men in those under 39, but without being significantly relevant to those over 40 years old.
As one of the reasons for this result, the research team pointed to the possibility that SGLT2 inhibitors were being prescribed to appropriate patients and were not being prescribed to patients prone to recurrent urinary tract infections.
Based on these results, the research team concluded that there is no evidence that SGLT2 inhibitors increase the risk of developing urinary tract infections in Japanese diabetic patients regardless of gender or age.
The research team emphasized, “As the indications expand to include chronic heart failure and chronic kidney disease, large-scale research is needed in diabetic patients with these diseases.”
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