Urogenital side effects in male subjects with type 2 diabetes treated with SGLT-2 inhibitors: A single centre, longitudinal observation

SGLT-2 inhibitors (SGLT-2i) provide good glycaemic control and weight loss, ensuring clinically relevant cardiorenal benefits in subjects with and without type 2 diabetes (T2D); however, their use is related to an enhanced risk of urogenital infections, mainly in female subjects. We performed a pros...

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Bibliographic Details
Published in:Journal of diabetes and its complications Vol. 39; no. 5; p. 109015
Main Authors: Del Zoppo, Alice, Rovera, Chiara, Petralli, Giovanni, Moriconi, Diego, Solini, Anna
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.05.2025
Elsevier Limited
Subjects:
Aged
Biochemistry
BMI
Clinical trials
Compliance
Creatinine
Diabetes
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - epidemiology
DPP-IV inhibitors
Fasting
Females
Genotype & phenotype
Glucose
Heart failure
Hospitals
Humans
Incidence
Infections
Laboratories
Longitudinal Studies
Male
Male Urogenital Diseases - chemically induced
Male Urogenital Diseases - epidemiology
Metabolism
Middle Aged
Prospective Studies
SGLT-2 inhibitors
Side effects
Sodium-Glucose Transporter 2 Inhibitors - adverse effects
Sodium-Glucose Transporter 2 Inhibitors - therapeutic use
Urogenital complications
DPP-IV inhibitors
SGLT-2 inhibitors
Compliance
Urogenital complications
BMI
ISSN:1056-8727, 1873-460X, 1873-460X
Online Access:Get full text
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Summary:SGLT-2 inhibitors (SGLT-2i) provide good glycaemic control and weight loss, ensuring clinically relevant cardiorenal benefits in subjects with and without type 2 diabetes (T2D); however, their use is related to an enhanced risk of urogenital infections, mainly in female subjects. We performed a prospective observation to assess incidence of urogenital complications in male sex new users of gliflozins. In the 2021–2023 years, solely based on clinical indication, we started such therapy in 272 male T2D subjects; follow up visits were performed after about 1 year. At follow up, 90 subjects had discontinued SGLT-2i; 36 of them (40 %) due to onset of urogenital symptoms. We observed 6 cases of phimosis. Subjects who discontinued the treatment due to these side effects had a higher BMI and a better eGFR at baseline and they were less frequently treated with DPP-IV inhibitors. A proper evaluation of the patient's phenotype might be useful in identifying subjects less prone to develop side effects driving SGLT-2i discontinuation; the combined use of SGLT-2i and DPP-IV inhibitors appears to be associated to a better long-term compliance to therapy in men. •Genito-urinary side effects in males treated with SGLT-2 inhibitors have been rarely evaluated in a real-life context.•High BMI and preserved kidney function, likely linked to increased glycosuria, might mark subjects at risk to discontinue SGLT-2i.•Combining SGLT-2 and DPP-IV inhibitors marks a better long-term compliance to therapy in men.
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ISSN:1056-8727
1873-460X
1873-460X
DOI:10.1016/j.jdiacomp.2025.109015