Research shows serious risk linked to diabetes drugs

Sodium-glucose cotransporter-2 (SGLT2) inhibitors, a newer class of drugs used to treat diabetes, have recently been associated with a rare but serious infection called Fournier gangrene.

This life-threatening condition affects the external genitalia, the perineum (the area between the genitals and anus), and the surrounding regions. Prompt medical attention is essential for anyone showing signs of this infection.

A recent study by the U.S. Food and Drug Administration (FDA) investigated the risks of SGLT2 inhibitors compared to other diabetes medications.

The researchers analyzed data on various treatments, including older drugs like metformin, insulin glargine, and short-acting insulin, as well as newer options like sitagliptin combined with metformin and dulaglutide.

From March 2013 to January 2019, the study identified 55 cases of Fournier gangrene in patients taking SGLT2 inhibitors.

These patients ranged in age from 33 to 87, with men making up the majority of cases (39 men and 16 women). The infection appeared at varying times after starting the medication, sometimes as early as five days or as late as nearly four years.

In addition to Fournier gangrene, these patients often experienced other serious diabetes-related complications, such as diabetic ketoacidosis (a dangerous build-up of acid in the blood), sepsis, and kidney damage.

To better understand the risk, the researchers compared these findings to data from patients on other diabetes drugs over a much longer timeframe, spanning from 1984 to 2019.

During this period, only 19 cases of Fournier gangrene were linked to other diabetes medications, suggesting that SGLT2 inhibitors may carry a higher risk of this infection.

This discovery has prompted health experts to label Fournier gangrene as a newly recognized safety concern for SGLT2 inhibitors. Given the severity of the condition, doctors are urged to carefully monitor patients taking these drugs for early signs of infection, such as pain, redness, or swelling in the affected areas.

Catching the infection early can make a significant difference, as timely treatment can prevent it from worsening and reduce the risk of severe complications.

The study, led by Susan J. Bersoff-Matcha, was published in the Annals of Internal Medicine. It highlights the importance of weighing the benefits and risks of newer diabetes treatments like SGLT2 inhibitors.

While these drugs offer effective blood sugar control, patients and healthcare providers need to stay alert to potential side effects, ensuring that any issues are addressed quickly to protect patient health.

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