Genital Infection Risk Profile in Post-menopausal Women with Type 2 Diabetes Mellitus on Sodium-glucose Cotransporter-2 (SGLT2) Inhibitors
Gentile S1,2, Guarino G1, Della Corte T1,2, Satta E2-4, Pipicelli AMV5, Romano C2, Alfarone C2, Lamberti R6, Di Maio A6 and Strollo F7*
1Campania University “Luigi Vanvitelli”, Naples, Italy
2Nefrocenter Research and Nyx Start-UP, Naples, Italy
3Haemodialysis Center s.r.l. Nefrocenter Network, Naples, Italy
4Polyspecialist Nephrology Center CNP Srl, Nefrocenter Network SRL, Frattamaggiore, Italy
5Nephrology, Dialysis and Transplant Unit, Medical and Surgical Science Department, “A. Gemelli” University Polyclinic IRCCS Foundation, Catholic University of the Sacred Heart, Rome, Italy
5Metelliano Medical Center, Nefrocenter Network, Naples, Italy
6IRCCS San Raffaele Pisana, Rome, Italy
*Corresponding Author: Strollo F, IRCCS San Raffaele Pisana, Rome, Italy.
August 21, 2021; Published: December 27, 2021
Background: patients with type 2 diabetes mellitus (T2DM) often discontinue Sodium-Glucose Cotransporter-2-inhibitors (SGLT2-Is) despite high efficacy and safety due to genital infection (GI).
Aim of the study: to assess real-life GI risk profile in post-menopausal T2DM patients educated on strict hygiene-based prevention practices (SHBPPs) due to their intrinsic GI susceptibility.
Methods: 721 post-menopausal T2DM patients willing to follow SHBPPs were randomly assigned to three different SGLT2-Is (intervention group, IG, n=318) or other drugs (control group, CG, n=403) for three- months. Before and after treatment, they underwent routine lab tests and completed a specific questionnaire.
Results: GIs more often occurred (9.6 %; p < 0.001) among IG women non-adhering to SHBPPs (41.5%) vs. the 2.9% of adhering ones. Conversely CG women had superimposable GI rates (2.7% vs. 3.1%, respectively, p n.s.) whether or not adhering to SHBPPs (51.4 vs. 49.6%, respectively, p n.s.). The typical profile of women on SGLT2-Is at higher risk for GIs included (i) poor adherence to SHBPPs, (ii) older age, (iii) higher BMI, (iv) poor glucose control as witnessed by high HbA1c levels, and (v) antihypertensive drug utilization.
Conclusion: physicians should consider the importance of strict hygiene control in their post-menopausal T2DM patients undergoing SGLT2-I treatment and thus utilize better-focused education strategies in that specific subgroup to prevent or rehabilitate from repeated GIs.
Keywords: Type 2 Diabetes; SGLT2-Inhibitors; Genital Infections; Menopause; Prevention; Rehabilitation
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