Which anti-diabetic medication class is associated with increased risk of urinary tract infections and vaginal thrush in women?

Which anti-diabetic medication class is associated with increased risk of urinary tract infections and vaginal thrush in women?

• A. DPP-4 inhibitors
• B. GLP-1 receptor agonists
• C. SGLT2 inhibitors
• D. Metformin

Answer: (C)

SGLT2 inhibitors increase the risk of urinary tract infections and vaginal thrush because they cause glucose to spill into the urine (glucosuria) by blocking glucose reabsorption in the kidney. The extra glucose in the urinary tract provides a resource for bacteria and fungi, promoting infections such as UTIs and vulvovaginal candidiasis, which are more noticeable in women. Other diabetes drug classes listed do not cause glucosuria and have different side effect profiles: DPP-4 inhibitors mainly cause GI issues or rare pancreatitis risk; GLP-1 receptor agonists cause GI symptoms and weight loss; metformin mainly causes GI upset with no specific infection risk. SGLT2 inhibitors also offer glycemic and CV/renal benefits, but patients should be counseled to recognize symptoms of infections and seek treatment if they occur.

SGLT2 inhibitors increase the risk of urinary tract infections and vaginal thrush because they cause glucose to spill into the urine (glucosuria) by blocking glucose reabsorption in the kidney. The extra glucose in the urinary tract provides a resource for bacteria and fungi, promoting infections such as UTIs and vulvovaginal candidiasis, which are more noticeable in women. Other diabetes drug classes listed do not cause glucosuria and have different side effect profiles: DPP-4 inhibitors mainly cause GI issues or rare pancreatitis risk; GLP-1 receptor agonists cause GI symptoms and weight loss; metformin mainly causes GI upset with no specific infection risk. SGLT2 inhibitors also offer glycemic and CV/renal benefits, but patients should be counseled to recognize symptoms of infections and seek treatment if they occur.