The prevalence and predictor factors of urinary tract infection in type 2 diabetes mellitus patients receiving SGLT2 inhibitors in Qatar: A retrospective cohort study

Background and aims: Urinary Tract Infections (UTIs) are common in Type 2 Diabetes Mellitus (T2DM) patients. While Sodium-Glucose Co-Transporter 2 (SGLT2) inhibitors improve T2DM treatment by lowering blood glucose, they may increase UTI risk. Research findings on this association are mixed. This study aims to determine UTI prevalence and identify risk factors in elderly T2DM patients using SGLT2 inhibitors, to enhance treatment strategies and patient safety.Methods A retrospective cohort study was conducted at two hospitals to evaluate UTI prevalence and predictors in elderly T2DM patients treated with SGLT2 inhibitors. Data from electronic health records over one year were analysed. Patients aged 60 + with a UTI diagnosis within 90 days of starting SGLT2 inhibitors were included. The primary outcome was UTI prevalence; secondary outcomes included factors like age, gender, comorbidities, HbA1c levels, and kidney function.Results In a cohort of 1,024 elderly T2DM patients, 49% experienced UTIs. Significant predictors included gender, nationality, and age. Females had a higher UTI prevalence (68% vs. 32%, p < 0.001), and Qatari patients had a higher UTI prevalence compared with non-Qatari patients (63% vs. 37%, p = 0.03). Older age was associated with higher UTI risk (p < 0.001). There were no significant associations with HbA1c levels, creatinine levels, or medication duration. Logistic regression confirmed females and older age as significant UTI predictors. These findings highlight demographic factors’ importance in UTI risk among T2DM patients on SGLT2 inhibitors.Conclusion The study identified varying risks of urinary tract infections (UTIs) among users of SGLT2 inhibitors, influenced by factors like gender, age, and existing health conditions. This underscores the need for cautious prescribing of SGLT2 inhibitors, emphasising personalised risk assessment and careful evaluation of benefits versus risks. Future research should focus on refining UTI risk prediction and developing targeted interventions for this patient population.