SGLT-2 inhibitor use shows no risk increase in UTI diagnosis among veterans

The use of SGLT-2 inhibitors does not appear to pose an elevated risk of urinary tract infection (UTI) among male veterans with type 2 diabetes (T2D), a recent study has shown.

A team of investigators conducted this retrospective cohort study and identified male veterans with T2D on metformin with a new fill of SGLT-2 inhibitors or sulfonylurea (SU) between 1 January 2020 and 31 December 2022. They examined patients for UTI diagnosis and calculated an adjusted odds ratio (aOR).

Among veterans treated with SGLT-2 inhibitors, 5.2 percent were diagnosed with outpatient UTI and 1.6 percent with inpatient UTI. In the SU cohort, 5.3 percent of patients were diagnosed with outpatients UTI and 1.3 percent with inpatient UTI.

In logistic regression analysis, the odds of outpatient UTI diagnosis were lower in the SGLT-2 inhibitor cohort than the SU cohort (aOR, 0.91, 95 percent confidence interval [CI], 0.86–0.96; p<0.001). No significant between-group difference was noted in the diagnosis of inpatient UTI (aOR, 1.06, 95 percent CI, 0.96–1.18; p=0.234).

“This retrospective study of national Veterans Health Administration data adds to growing literature which finds no excessive risk of UTI associated with SGLT-2 inhibitor therapies,” the investigators said.

SGLT-2 inhibitors possessed a presumed increased UTI risk due to their mechanism of action, as reflected in current prescribing data, according to the investigators.

"As SGLT-2 inhibitor prescribing trends increase, some retrospective studies confirm an increased risk of UTI while conflicting studies find no increased risk of UTI associated with this therapy,” they said.