The Impact of Glycemic Control on Sodium-Glucose Co-Transporter 2 Inhibitor–Associated Genitourinary Infections.

This article focuses on the association between genitourinary (GU) infections and hemoglobin A1C levels in patients with type 2 diabetes (T2D) initiated on sodium-glucose co-transporter 2 inhibitors (SGLT2is). A retrospective study of 328 adult T2D patients at a New York City primary care clinic found a statistically significant higher risk of GU infections in those with baseline A1C ≥9% compared to those with A1C <9%, with fungal infections, particularly Candida albicans, being most common. Additional factors associated with increased GU infection risk included female sex, longer duration of diabetes (≥10 years), and insulin use, while ethnicity, body mass index, age, estimated glomerular filtration rate, and specific SGLT2i type showed no significant impact. The findings suggest that clinicians might consider alternative or adjunctive antiglycemic therapies for patients with poor glycemic control to mitigate infection risk, though further prospective research is needed to confirm these results.