SGLT2 Inhibitors and Diabetes: Double Trouble for Genital Mycotic Infections

Patients with diabetes may already be at increased risk for genital mycotic infections. Type 2 diabetes (T2DM) is associated with an increased risk for asymptomatic bacteriuria, urinary tract infections, balanitis, vulvovaginal infections, acute pyelonephitris, and bacteremia. Glucosuria, increased bacterial adherence to uroepithelium, and immune dysfunction may all play roles. Candida albicans has a glucose-inducible protein that facilitates yeast adhesion to genital epithelium and interferes with immune phagocytosis.