Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

DIABETES

SGLT2 inhibitors and urinary tract infections

Sodium–glucose cotransporter 2 (SGLT2) inhibitors are a fairly new class of treatment for diabetes mellitus. Some data suggest SGLT2 inhibitors are associated with a risk of severe urinary tract infections. However, meta-analyses of trials and a large population-based cohort study show no increased risk, which provides important reassurance for patients and prescribers.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Zelniker, T. A. et al. SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet 393, 31–39 (2019).

    Article  CAS  Google Scholar 

  2. Food and Drug Administration. Postmarket drug safety information for patients and providers: sodium-glucose cotransporter-2 (SGLT2) inhibitors. FDA https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/sodium-glucose-cotransporter-2-sglt2-inhibitors (2019).

  3. Hirji, I. et al. Incidence of urinary tract infection among patients with type 2 diabetes in the UK General Practice Research Database (GPRD). J. Diabetes Complications 26, 513–516 (2012).

    Article  Google Scholar 

  4. Schneeberger, C., Holleman, F. & Geerlings, S. E. Febrile urinary tract infections: pyelonephritis and urosepsis. Curr. Opin. Infect. Dis. 29, 80–85 (2016).

    Article  Google Scholar 

  5. Puckrin, R. et al. SGLT-2 inhibitors and the risk of infections: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol. 55, 503–514 (2018).

    Article  CAS  Google Scholar 

  6. Radholm, K. et al. Effects of sodium-glucose cotransporter-2 inhibitors on cardiovascular disease, death and safety outcomes in type 2 diabetes - a systematic review. Diabetes Res. Clin. Pract. 140, 118–128 (2018).

    Article  Google Scholar 

  7. Wiviott, S. D. et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N. Engl. J. Med. 380, 347–357 (2018).

    Article  Google Scholar 

  8. Bersoff-Matcha, S. J. et al. Fournier gangrene associated with sodium-glucose cotransporter-2 inhibitors a review of spontaneous postmarketing cases. Ann. Intern. Med. 170, 764–769 (2019).

    Article  Google Scholar 

  9. Dave, C. V. et al Sodium-glucose cotransporter-2 inhibitors and the risk for severe urinary tract infections: a population-based cohort study. Ann. Intern. Med. 171, 248–256 (2019).

    Article  CAS  Google Scholar 

  10. Perkovic, V. et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N. Engl. J. Med. 380, 2295–2306 (2019).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John Wilding.

Ethics declarations

Competing interests

JW has undertaken consultancy work and given lectures on behalf of Astellas, AstraZeneca, Boehringer Ingelheim, Janssen, Merck Sharpe and Dohme, all of whom produce SGLT2 inhibitors. JW has been an investigator for several SGLT2 inhibitor trials and was a member of the DECLARE TIMI-58 trial steering committee. JW has also undertaken consultancy, undertaken clinical trials and given lectures on behalf of companies that produce other treatments for diabetes mellitus, namely Novo Nordisk, Eli Lilly, Sanofi and Takeda. JW received renumeration for time spent as a consultant and time spent on clinical trials via his employing institution, the University of Liverpool.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wilding, J. SGLT2 inhibitors and urinary tract infections. Nat Rev Endocrinol 15, 687–688 (2019). https://doi.org/10.1038/s41574-019-0275-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41574-019-0275-6

This article is cited by

Search

Quick links

Nature Briefing: Translational Research

Sign up for the Nature Briefing: Translational Research newsletter — top stories in biotechnology, drug discovery and pharma.

Get what matters in translational research, free to your inbox weekly. Sign up for Nature Briefing: Translational Research