FREQUENCY OF URINARY TRACT INFECTIONS IN PATIENTS TAKING SODIUM-GLUCOSE COTRANSPORTER-2 (SGLT-2) INHIBITORS

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a globally prevalent metabolic disorder associated with significant morbidity. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors have emerged as effective antihyperglycemic agents, enhancing renal glucose excretion to improve glycemic control. Despite their benefits, concerns have arisen regarding an increased risk of urinary tract infections (UTIs) in patients using these medications. This study aimed to determine the frequency of UTIs in T2DM patients using SGLT-2 inhibitors at a tertiary care hospital in Karachi.

Objective: To assess the incidence of UTIs and identify associated risk factors in T2DM patients receiving SGLT-2 inhibitors.

Methods: A descriptive cross-sectional study was conducted at Jinnah Sindh Medical University, Karachi, including 215 T2DM patients aged 30–65 years who had been on SGLT-2 inhibitors for over one month. Patients were selected using non-probability consecutive sampling. Exclusion criteria included type 1 diabetes, pregnancy, recurrent UTIs, severe renal impairment, and immunosuppressive therapy. Data collection involved structured interviews, medical record reviews, and urine culture analysis. Variables assessed included gender, glycemic control (HbA1c), comorbidities, hemoglobin levels, and duration of diabetes. Statistical analysis was performed using SPSS version 27.0, with a p-value <0.05 considered significant.

Results: Among the 215 participants, 32 (14.9%) were diagnosed with UTIs. Female patients had a significantly higher incidence of UTIs compared to males (62.5% vs. 37.5%, p = 0.02). Poor glycemic control (HbA1c > 8%) was strongly associated with UTI occurrence (96.9% vs. 87.9%, p = 0.01). The mean duration of diabetes was 7.5 ± 3.2 years, and patients with UTIs had significantly lower hemoglobin levels (10.3 ± 1.7 g/dL) compared to those without UTIs (10.7 ± 1.2 g/dL, p = 0.027).

Conclusion: The study identified a substantial incidence of UTIs in T2DM patients on SGLT-2 inhibitors, with female gender and poor glycemic control being significant risk factors. These findings underscore the importance of monitoring and preventive strategies to mitigate UTI risks in high-risk populations.