, Volume 59, Issue 3, pp 690–693 | Cite as

Lower urinary tract symptoms (LUTS) in males with type 2 diabetes recently treated with SGLT2 inhibitors—overlooked and overwhelming? A retrospective case series

  • Nino Cristiano Chilelli
  • Giuseppe Bax
  • Giulio Bonaldo
  • Eugenio Ragazzi
  • Massimo Iafrate
  • Filiberto Zattoni
  • Federico Bellavere
  • Annunziata LapollaEmail author
Research Letter


As outlined in the latest recommendations for patients with type 2 diabetes (DM2), sodium glucose cotransporter 2 inhibitors (SGLT2i) can be added on treatments with metformin or sulfonylurea plus metformin if glycemic goals are not met [1]. Genital and urinary infections are well-known side effects of SGLT2i, with reported odds ratios in the range of 3.21–5.23, compared with placebo [2, 3].

Lower urinary tract symptoms (LUTS) are urological complications occurring in patients with DM2—males in particular—, whereas little is known about their prevalence in patients treated with SGLT2i [4]. This association is of particular interest because a symptom such as polyuria—often reported by patients starting treatment with SGLT2i—may be the sign of a urological predisposing conditions, rather than a side effect of a new treatment.

Hence this case-series on male patients who had recently started treatment with SGLT2i, to assess the prevalence of new-onset LUTS. We documented any...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


  1. 1.
    W.T. Cefalu, M.C. Riddle, SGLT2 inhibitors: the latest “new kids on the block”! Diabetes Care 38(3), 352–354 (2015)CrossRefGoogle Scholar
  2. 2.
    D. Li, T. Wang, S. Shen, Z. Fang, Y. Dong, H. Tang, Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: a meta-analysis of randomized controlled trials. Diabetes Obes. Metab. Epub ahead of print (2016)Google Scholar
  3. 3.
    W.T. Cefalu, L.A. Leiter, K.H. Yoon et al. Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52 week results from a randomised, double-blind, phase 3 non-inferiority trial. Lancet 382, 941–950 (2013)CrossRefGoogle Scholar
  4. 4.
    H. Yamasaki, K. Ogawa, H. Sasaki et al. Prevalence and risk factors of erectile dysfunction in Japanese men with type 2 diabetes. Diabetes Res. Clin. Pract. 66(Suppl 1), S173–S177 (2004)CrossRefGoogle Scholar
  5. 5.
    G.N. Collins, G.M. Raab, M. Hehir, B. King, W.M. Garraway, Observer variability and reproducibility of transrectal ultrasound in the measurement of prostatic volume. Ultrasound Med. Biol. 21, 1101 (1995)CrossRefGoogle Scholar
  6. 6.
    N. Kebapci, A. Yenilmez, B. Efe, E. Entok, C. Demirustu, Bladder dysfunction in type 2 diabetic patients. Neurourol. Urodyn. 26, 814–819 (2007)CrossRefGoogle Scholar
  7. 7.
    S. Geerlings, V. Fonseca, D. Castro-Diaz, J. List, S. Parikh, Genital and urinary tract infections in diabetes: impact of pharmacologically-induced glucosuria. Diabetes Res. Clin. Pract. 103, 373–381 (2014)CrossRefGoogle Scholar
  8. 8.
    C.C. Wang, M.B. Chancellor, J.M. Lin, J.H. Hsieh, H.J. Yu, Type 2 diabetes but not metabolic syndrome is associated with an increased risk of lower urinary tract symptoms and erectile dysfunction in men aged <45 years. BJU Int. 105, 1136–1140 (2010)CrossRefGoogle Scholar
  9. 9.
    H.J. Song, E.J. Lee, N. Bergstrom, D.H. Kang, D.H. Lee, G. Koh, J.S. Huh, S.D. Kim, S.C. Hong, S.S. Moon, J. Kang, Lower urinary tract symptoms and erectile dysfunction in men with type 2 diabetes mellitus. Int. Neurourol. J. 17, 180–185 (2013)CrossRefGoogle Scholar
  10. 10.
    T. Heise, E. Seewaldt-Becker, S. Macha et al. Safety, tolerability, pharmacokinetics and pharmacodynamics following 4 weeks’ treatment with empagliflozin once daily in patients with type 2 diabetes. Diabetes Obes. Metab. 15, 613–621 (2013)CrossRefGoogle Scholar
  11. 11.
    S.O. Kim, H.S. Choi, Y.J. Kim et al. Impact of nocturia on health-related quality of life and medical outcomes study sleep score in men. Int. Neurourol. J. 15, 82–86 (2011)CrossRefGoogle Scholar
  12. 12.
    P.A. Low, L.M. Benrud-Larson, D.M. Sletten, T.L. Opfer-Gehrking, S.D. Weigand, P.C. O’Brien, G.A. Suarez, P.J. Dyck, Autonomic symptoms and diabetic neuropathy: a population-based study. Diabetes Care 27, 2942–2947 (2004)CrossRefGoogle Scholar
  13. 13.
    K. Rafiq, Y. Fujisawa, S.J. Sherajee, A. Rahman, A. Sufiun, H. Kobori, H. Koepsell, M. Mogi, M. Horiuchi, A. Nishiyama, Role of the renal sympathetic nerve in renal glucose metabolism during the development of type 2 diabetes in rats. Diabetologia 58, 2885–2898 (2015)CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Diabetology and Dietetics Unit, Department of MedicineUniversity of PadovaPadovaItaly
  2. 2.Urology Clinic, Department of Oncological and Surgical SciencesUniversity of PadovaPadovaItaly
  3. 3.Department of Pharmaceutical and Pharmacological SciencesUniversity of PadovaPadovaItaly
  4. 4.Rizzola Foundation HospitalVeneziaItaly

Personalised recommendations