Unnikrishnan A G, Kalra Sanjay, Purandare Vedavati, Vasnawala Hardik
Department of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India.
Department of Endocrinology, Bharti Research Institute of Diabetes, Bharti Hospital, Karnal, Haryana, India.
Indian J Endocrinol Metab. 2018 Nov-Dec;22(6):837-842. doi: 10.4103/ijem.IJEM_159_17.
Diabetes is a metabolic disorder characterized by hyperglycemia and is associated with several comorbidities and complications. Genital infection is one such complication that is often associated with diabetes mellitus (DM). Even though abnormalities in immune system, high urine glucose, and bladder dysfunction are important contributors for the increased risk of genitourinary symptoms, yet the possible role of pharmacologically induced glucosuria cannot be completely overlooked in such patients. There are various classes of medications to control blood glucose levels. A new therapeutic option to manage hyperglycemia is to increase renal glucose excretion by inhibiting sodium-glucose cotransporter-2 (SGLT2) glucose transport proteins. SGLT2 inhibitors (SGLT2i) represent a novel class of oral antidiabetic drugs which are associated with drug-induced glucosuria. Currently, canagliflozin, dapagliflozin, and empagliflozin are the three SGLT2i approved for therapy in Type 2 DM (T2DM). Safety studies with these three SGLT2i have reported events of mild-moderate genital infections in patients on SGLT2i therapy. However, most of the reported infections responded to standard treatment. Apart from SGLT2i, factors including personal hygiene, menopause, and circumcision might have a possible role in reported events of genital infections among T2DM patients on SGLT2i therapy. The present review identifies the occurrence of genital infections in diabetic patients on SGLT2i therapy, factors affecting the incidence of genital infections, and management strategies in patients with T2DM on SGLT2i therapy.
糖尿病是一种以高血糖为特征的代谢紊乱疾病，与多种合并症和并发症相关。生殖器感染就是其中一种常与糖尿病（DM）相关的并发症。尽管免疫系统异常、高尿糖和膀胱功能障碍是泌尿生殖系统症状风险增加的重要因素，但在这类患者中，药物诱导性糖尿的潜在作用也不能被完全忽视。有多种药物可用于控制血糖水平。一种治疗高血糖的新方法是通过抑制钠-葡萄糖协同转运蛋白2（SGLT2）葡萄糖转运蛋白来增加肾脏葡萄糖排泄。SGLT2抑制剂（SGLT2i）是一类新型口服抗糖尿病药物，与药物诱导性糖尿有关。目前，卡格列净、达格列净和恩格列净是三种被批准用于治疗2型糖尿病（T2DM）的SGLT2i。对这三种SGLT2i的安全性研究报告了接受SGLT2i治疗的患者发生轻至中度生殖器感染的事件。然而，大多数报告的感染对标准治疗有反应。除了SGLT2i之外，包括个人卫生、绝经和包皮环切等因素可能在接受SGLT2i治疗的T2DM患者报告的生殖器感染事件中起作用。本综述确定了接受SGLT2i治疗的糖尿病患者生殖器感染的发生情况、影响生殖器感染发生率的因素以及接受SGLT2i治疗的T2DM患者的管理策略。
