From the Guidelines
Yes, certain diabetic medications, specifically sodium-glucose cotransporter-2 (SGLT2) inhibitors, increase the risk of urinary tract infections (UTIs). These medications include canagliflozin (Invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance), and ertugliflozin (Steglatro) 1. SGLT2 inhibitors work by preventing glucose reabsorption in the kidneys, causing excess glucose to be excreted in the urine. This increased urinary glucose creates an ideal environment for bacterial growth, particularly E. coli, which is the most common cause of UTIs. Patients taking these medications should be vigilant about UTI symptoms such as:
- Frequent urination
- Burning sensation during urination
- Cloudy or strong-smelling urine
- Pelvic pain To reduce UTI risk while on these medications, patients should:
- Maintain good hydration
- Practice proper hygiene
- Urinate after sexual activity
- Avoid holding urine for extended periods Despite this side effect, SGLT2 inhibitors offer significant benefits for diabetes management and cardiovascular protection, so the risk-benefit profile remains favorable for many patients 1.
From the Research
Diabetic Medications and UTI Risk
- Certain diabetic medications have been associated with an increased risk of urinary tract infections (UTIs) 2, 3, 4.
- SGLT-2 inhibitors, a class of anti-hyperglycemic agents, have been linked to a higher risk of genitourinary infections, including UTIs 2, 4.
- A network meta-analysis found that SGLT-2 inhibitors combined with metformin may have a reduced risk of UTIs compared to other SGLT-2 inhibitors 3.
- A retrospective cohort study in Korea found that SGLT-2 inhibitors as an add-on therapy to metformin were associated with a higher risk of genital and urinary tract infections compared to DPP-4 inhibitors, sulfonylurea, and thiazolidinedione 4.
Specific Medications and UTI Risk
- Ertugliflozin, a type of SGLT-2 inhibitor, was found to have a reduced risk of UTIs compared to other SGLT-2 inhibitors in some studies 3.
- Empagliflozin, another SGLT-2 inhibitor, was found to have a reduced risk of UTIs compared to ertugliflozin and dapagliflozin in high-dose comparisons 3.
- Metformin, a commonly used diabetic medication, was not found to have a significant association with UTI risk in the studies reviewed 3, 5.
- Sulfonylureas and thiazolidinediones, other types of diabetic medications, were not found to have a significant association with UTI risk in the studies reviewed 5, 6.