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

OBJECTIVE

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.

SUBJECTS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

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