Clinical risk factors predicting genital fungal infections with sodium-glucose cotransporter 2 inhibitor treatment: The ABCD nationwide dapagliflozin audit

Introduction: Treatment of type 2 diabetes with sodium -glucose cotransporter 2 (SGLT2) inhibitors may result in genital fungal infections. We investigated possible risk factors for developing such infections among patients treated with the SGLT2 inhibitor dapagliflozin. Methods: The Association of British Clinical Diabetologists (ABCD) collected data on patients treated with dapagliflozin in routine clinical practice from 59 diabetes centres. We assessed possible associations of patient's age, diabetes duration, body mass index, glycated haemoglobin, renal function, patient sex, ethnicity and prior genital fungal infection, urinary tract infection, urinary incontinence or nocturia, with the occurrence of >= 1 genital fungal infection within 26 weeks of treatment. Results: 1049 out of 1116 patients (476 women, 573 men) were analysed. Baseline characteristics were, mean +/- SD, age 56.7 +/- 10.2 years, BMI 35.5 +/- 6.9 kg/m(2) and HbA(1c), 9.4 +/- 1.5%. Only patient sex (13.2% women vs 3.3% men) and prior history of genital fungal infection (21.6% vs 7.3%) were found to be associated with occurrence of genital fungal infections after dapagliflozin treatment, adjusted OR 4.22 [95%CI 2.48,7.19], P <0.001 and adjusted OR 2.41 [95% CT 1.04,5.57], P=0.039, respectively. Conclusion: Women and patients with previous genital fungal infections had higher risks of developing genital fungal infections with dapagliflozin treatment. (C) 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.