Evidence mapPaperPMID 41021225Full record

ArticleJAMA network open2025

SGLT2 Inhibitors and External Genital Infection in Male Patients With Type 2 Diabetes.

Tsung-Han Cheng, Kun-Che Lin, Albert Tzu-Ming Chuang, Michael Chun-Yuan Cheng, Shih-Chieh Shao, Swu-Jane Lin, Tsung-Yen Lin, Yuh-Shyan Tsai, Edward Chia-Cheng Lai, Che-Yuan Hu and 1 more

Abstract read
In one paragraph

Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Tsung-Han ChengDivision of Urology, Department of Surgery, Kaohsiung Show Chwan Memorial Hospital, Kaohsiung, Taiwan.
Kun-Che LinDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Albert Tzu-Ming ChuangSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Michael Chun-Yuan ChengSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Shih-Chieh ShaoSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Swu-Jane LinDepartment of Pharmacy Systems, Outcomes & Policy, College of Pharmacy, University of Illinois at Chicago, Chicago.
Tsung-Yen LinDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Yuh-Shyan TsaiDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Edward Chia-Cheng LaiSchool of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Che-Yuan HuDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Kuan-Yu WuDepartment of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceNew medications for type 2 diabetes (T2D) control, such as sodium-glucose cotransporter-2 inhibitors (SGLT2Is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs), have emerged. However, the US Food and Drug Administration has warned about potential risks of Fournier gangrene, a severe genital infection associated with SGLT2I use.

objectiveTo determine comparative risks of male external genital infections (MEGIs) in adult male patients with T2D treated with SGLT2Is. DESIGN, SETTING, AND

participantsA population-based cohort study analyzing Taiwan's National Health Insurance Research Database was conducted to evaluate the MEGI risk in adult male patients with T2D newly treated with SGLT2Is between January 1, 2009, and December 31, 2020. Patients newly treated with GLP-1RAs were chosen during the same period for the active-comparator group, and propensity scores with inverse probability of treatment weighting were applied to balance the baseline characteristics between the 2 treatment groups. Data analyses were conducted between February 2023 and April 2025. EXPOSURES: Treatment with SGLT2Is or GLP-1RAs. MAIN OUTCOMES AND MEASURES: The primary outcome was the incidence of MEGI, identified using International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes. To examine the result consistency, subgroup analyses based on age (older or younger than 60 years), diabetes severity (insulin use or not), and kidney function were conducted.

resultsThe study included 239 757 patients; 224 360 initiated SGLT2Is (mean [SD] age, 58.4 [12.3] years) and 15 397 initiated GLP-1RAs (mean [SD] age, 58.1 [13.6] years). Compared with the GLP-1RA group, the SGLT2I group had a significantly increased risk of MEGI (hazard ratio [HR], 1.65; 95% CI, 1.59-1.71). The subgroup analyses indicated an increased risk of MEGI in the SGLT2I group among patients younger than 60 years (HR, 2.04; 95% CI, 1.58-2.65), those with an estimated glomerular filtration rate of 60 mL/min/1.73 m2 (HR, 1.69; 95% CI, 1.34-2.15), and those with hemoglobin A1c below 7% (HR, 3.22; 95% CI, 1.71-6.03). CONCLUSIONS AND RELEVANCE: These findings suggest that SGLT2Is are associated with a higher risk of MEGI in adult male patients with T2D, compared with GLP-1RAs. Clinicians should be cautious when prescribing SGLT2Is in male patients with T2D.

Indexed as

Diabetes Mellitus, Type 2Fournier GangreneGenital Diseases, MaleSodium-Glucose Transporter 2 InhibitorsAdultAgedCohort StudiesGlucagon-Like Peptide-1 Receptor AgonistsHumansHypoglycemic AgentsIncidenceMaleMiddle AgedTaiwanGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID41021225
PMCPMC12481227

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.