DPP4i and SGLT2i Impact on Genitourinary Infections

SGLT2i and Genitourinary Infection Risk

SGLT2i therapy is associated with a significantly higher risk of genital mycotic infections (6% of patients on SGLT2i vs. 1% on placebo) 1

Counsel patients on proper genital hygiene before and during SGLT2i therapy 2
Most genital mycotic infections can be treated with standard antifungal therapy without discontinuing SGLT2i 2
Consider temporary discontinuation of SGLT2i in severe or recurrent UTIs 2
Discontinue SGLT2i immediately for severe infections or Fournier's gangrene 2

SGLT2i should be used cautiously in patients with recurrent or severe urinary tract infections 3
For patients with chronic kidney disease, SGLT2i benefits on kidney and cardiovascular outcomes generally outweigh the risk of genitourinary infections 1, 4
Additional research is needed to determine the role of SGLT2i in patients post-transplant, as immunosuppression may modify infection risks 1

Provide thorough education on hygiene and early symptom recognition for high-risk patients on SGLT2i 2
Consider alternative antidiabetic agents if infections become burdensome 3
Implement preventive strategies and close monitoring if SGLT2i benefits outweigh risks 2
Monitor for symptoms of genitourinary infections during follow-up visits 2
Treat most infections with standard therapy without discontinuing SGLT2i 2
Discontinue SGLT2i only for severe infections or Fournier's gangrene 2