The impact of sodium-glucose co-transporter 2 inhibitors on the incidence of non-tuberculous mycobacteria infection in diabetes populations.

PURPOSE: Sodium glucose co-transporter 2 inhibitors (SGLT2i) not only control blood sugar but also exhibit cardiovascular and renal protection via inflammation modulation. But there is scarce information about the impact of SGLT2i on infections, especially non-tuberculous mycobacteria (NTM) infection.

METHODS

This retrospective study screened the Taiwan National Health Insurance Research Database from 2016 to 2021, and enrolled subjects aged more than 20 years with initial diagnoses of type 2 diabetes mellitus (T2DM) in 2017-2021. The subjects were categorized into two groups based on whether SGLT2i were used (SGLT2i and non-SGLT2i users).

RESULTS

A total of 853720 subjects were enrolled. Of these, 91181 individuals were identified as the SGLT2i users, while the remaining 762539 were classified as the non-SGLT2i users. The prevalence of NTM infection was lower in the SGLT2i users than in the non-SGLT2i (0.05 % v. 0.14 %, p < 0.001). Multivariable analysis of factors associated with NTM infection showed that SGLT2i use was associated with a lower risk of NTM infection (adjusted hazard ratio: 0.44, p < 0.001), whereas male, age of 35 years or more, cancer and chronic airway diseases were associated with a higher risk of NTM infection. Diabetes complication tended to be associated with NTM infection only when the diabetes complications severity index (DCSI) was ≧ 3 ( p = 0.050).

CONCLUSIONS

SGLT2i use was less associated with NTM infection. In addition, adequate management of co-morbidities and good glycemic control to avoid complications were also associated with reduced risk of NTM infection.