From the Guidelines
Yes, Sodium-Glucose Linked Transporter 2 (SGLT2) inhibitors can affect the skin, particularly in terms of increasing the risk of genital mycotic infections, which are more common in women 1.
Key Points
- SGLT2 inhibitors may cause clinically significant volume depletion, and patients should be advised to monitor for signs of volume depletion such as orthostatic lightheadedness 1.
- The risk of genital mycotic infections can be lowered with meticulous attention to personal hygiene, and topical antifungal agents can be used for initial treatment 1.
- Patients should be informed about the unlikely risk of euglycemic diabetic ketoacidosis and advised to seek immediate care if they develop symptoms potentially associated with diabetic ketoacidosis 1.
- SGLT2 inhibitors have been associated with an increased risk of acute kidney injury, dehydration, and orthostatic hypotension; caution should be taken when SGLT2 inhibitors are used in combination with diuretics and/or ACE inhibitors and angiotensin receptor blockers 1.
- Canagliflozin has been associated with increased risk for lower-limb amputation and fracture risk 1.
Important Considerations
- Patients taking SGLT2 inhibitors should be advised to self-monitor blood glucose levels closely during the first 3 to 4 weeks after initiating SGLT2 inhibitors 1.
- The dose of SGLT2 inhibitors should be reduced in patients with moderate renal impairment and discontinued in severe renal impairment 1.
- Common adverse effects of SGLT2 inhibitors are genitourinary tract infections, and rare adverse reactions include increased risk of ketoacidosis, acute kidney injury, bone fracture, and need for toe amputation (canagliflozin) 1.
From the Research
SGLT2 Inhibitors and Skin Effects
- There is no direct evidence in the provided studies that SGLT2 inhibitors have a specific effect on the skin 2, 3, 4, 5, 6.
- The studies primarily focus on the antidiabetic and cardioprotective effects of SGLT2 inhibitors, as well as their impact on various organ systems such as the kidneys, cardiovascular system, and liver 3, 4, 5, 6.
- However, some studies mention adverse effects such as urinary tract and genital infections, which may have indirect implications for skin health 2, 3, 4, 5.
- One study mentions Fournier gangrene as a potential adverse effect of SGLT2 inhibitors, which is a serious skin infection 3.
- Overall, while there is limited direct evidence on the effects of SGLT2 inhibitors on the skin, it is possible that some adverse effects may have indirect implications for skin health.
Adverse Effects of SGLT2 Inhibitors
- Urinary tract and genital infections are common adverse effects of SGLT2 inhibitors 2, 3, 4, 5.
- Other adverse effects include euglycemic diabetic ketoacidosis, lower limb amputations, Fournier gangrene, risk of bone fractures, female breast cancer, male bladder cancer, orthostatic hypotension, and acute kidney injury 3, 5.
- These adverse effects may have indirect implications for skin health, particularly in the case of Fournier gangrene, which is a serious skin infection 3.