Active Diabetes, Hormones & Metabolism NIHR-supported project Digestion, Kidneys & Other Organs

Decreasing the risk of UTI in Type 2 Diabetes Mellitus patients on SGLT2 inhibitors

In plain English

AI plain-English summary

A common diabetes drug is flooding patients’ urine with sugar, and that sugar is feeding bacteria that cause painful urinary tract infections. Researchers want to find out exactly which microbes are taking advantage of this sugary environment. The problem is straightforward: SGLT2 inhibitors lower blood glucose by dumping excess sugar into urine, but that same sugar-rich urine creates a breeding ground for infection. Doctors know the risk exists, but they don’t know which specific microorganisms are responsible, or whether patients on these drugs need different screening or treatment than other diabetes patients. This study will compare urine samples from 15 patients on SGLT2 inhibitors with 15 patients on other diabetes drugs, culturing the microbes and measuring glucose levels and inflammation markers. If the research succeeds, it could change how doctors monitor and treat UTIs in the roughly 5 million UK patients with type 2 diabetes. Instead of prescribing broad-spectrum antibiotics, clinicians might screen for specific pathogens and tailor treatment accordingly. This could reduce antibiotic resistance, shorten infection duration, and prevent recurrent UTIs that otherwise degrade quality of life and strain primary care services.

View original technical description
Type 2 diabetes mellitus (T2DM) is a disease that results in elevated blood glucose levels and increased risk of urinary tract infections (UTIs). Sodium glucose co-transporter 2 inhibitors (SGLT2i) are often prescribed to T2DM patients to lower blood glucose levels by suppressing glucose reabsorption in the kidneys. This increases the urinary glucose concentration and is associated with an increased risk of UTIs.In this study we hope to recruit 15 T2DM patients with UTIs who are on SGLT2i and match them to 15 T2DM patients with UTIs who are on medications that do not affect the kidney. Recruited patients will submit a urine sample that will be cultured for microorganisms to determine the types of microorganisms present. Biochemical tests will also be performed to measure the concentration of glucose in the urine samples and the level of inflammation. Microbiological and biochemical tests will be compared with the medication prescribed to determine if SGLT2i are associated with the presence of specific microorganisms and if patients on SGLT2i need to be screened for specific microorganisms in their urine to prevent UTIs.

Researchers

Alison Mather (Principal Investigator)

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