SGLT2 inhibitor initiation by patients with type 2 diabetes is associated with a 2-4 times increased risk of genital tract infections compared with other classes of antihyperglycaemics, real-world data confirm.

Researchers have drawn on UK primary care and Canadian administrative healthcare data for more than 50,000 new metformin users initiating second-line agents to compare their risk of the gamut of genital infections, ranging from thrush to Fournier’s gangrene. 

They found patients who were initiated on the SGLT2 inhibitors canagliflozin, dapagliflozin and empagliflozin had an overall twofold increased risk of genital tract infections compared with patients using DPP-4 inhibitors.

Singly, dapagliflozin was associated with a 2.4-fold increased risk, empagliflozin a 2.3-fold increased risk and canagliflozin (no longer registered in Australia) a nearly fourfold increased risk.