Sodium-glucose cotransporter 2 inhibitors were associated with a higher risk of phimosis and a potential long-term risk of penile cancer in men with type 2 diabetes. These findings were presented at the European Association for the Study of Diabetes (EASD) 2025.

This population-based cohort study included 32,486 men initiating sodium-glucose cotransporter 2 inhibitors and 14,793 men starting glucagon-like peptide-1 receptor agonists in Denmark between 2016 and 2021. The groups were balanced for 41 confounders using inverse probability of treatment weighting. 

Within the first year, phimosis occurred in 0.9% of sodium-glucose cotransporter 2 inhibitor users compared with 0.5% of glucagon-like peptide-1 receptor agonist users, with an 8-year cumulative risk of 4.8% versus 3.6% and a risk ratio of 1.36 (95% confidence interval 1.14–1.61). Penile cancer cases were rare but more frequent in sodium-glucose cotransporter 2 inhibitor users over eight years (0.09% vs 0.01%; risk ratio 6.34, 95% CI 1.16–34.52).

While absolute risks of penile cancer remain low, these results highlight the importance of monitoring genital health in men initiating sodium-glucose cotransporter 2 inhibitors.