Concerns about urinary frequency and lower urinary tract symptoms (LUTS) continue to influence prescribing decisions for sodium-glucose cotransporter-2 inhibitors (SGLT2i), despite their established cardiovascular and renal benefits in patients with type 2 diabetes mellitus (T2DM). A prospective observational study published in Diabetology International evaluated whether SGLT2i therapy affects LUTS severity in adults with T2DM.

The study included 47 adults with T2DM who initiated SGLT2i therapy and had no evidence of organic urinary tract disease or autonomic neuropathy. Lower urinary tract symptoms were assessed using the Overactive Bladder-Validated 8-question (OAB-V8) questionnaire at baseline and reassessed after 1 and 3 months of treatment.

Findings

• Mean overall OAB-V8 scores decreased from 10.1 ± 5.0 at baseline to 8.8 ± 6.5 at month 1 (p = 0.01), with no significant difference from baseline at month 3 (p = 1.00).
• Among 17 patients with OAB at baseline, scores decreased from 15.4 ± 4.0 to 12.4 ± 5.7 at month 1 (p = 0.04), before returning to baseline levels at month 3 (16.0 ± 9.0; p = 0.69).
• Among 30 patients without OAB, scores remained stable at month 1 (7.1 ± 2.3 to 6.9 ± 6.1; p = 0.24) and decreased at month 3 (6.6 ± 5.4; p = 0.03).
• Changes in OAB-V8 scores were independent of HbA1c or BMI levels in patients with and without OAB.

Short-term SGLT2i therapy was not associated with worsening of LUTS in adults with T2DM, although larger controlled studies with longer follow-up are needed to further evaluate urinary symptom patterns during treatment.