---
title: "Risk Factors for Recurrent Urinary Tract Infection After SGLT2 Inhibitor Reinitiation in Type 2 Di"
id: "pubmed-42803855"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42803855"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42803855/"
doi: "10.1007/s12020-026-04777-3"
published_at: "2026-09-28T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Risk Factors for Recurrent Urinary Tract Infection After SGLT2 Inhibitor Reinitiation in Type 2 Di
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42803855
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42803855/)
- **DOI:** [10.1007/s12020-026-04777-3](https://doi.org/10.1007%2Fs12020-026-04777-3)
- **Published At:** 2026-09-28T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective cohort study evaluated risk of **recurrent urinary tract infection (UTI)** after restarting **SGLT2 inhibitors** in adults with type 2 diabetes who stopped the drug during an index UTI and were later reinitiated. - Patients were classified by reinitiation timing: early (<21 days) versus delayed (≥21 days). Recurrent UTI required a new coded clinical encounter after reinitiation and an associated antibiotic prescription. - In a subgroup of 316 patients restarted within 21 days, 43.99% experienced recurrence within 14 days after reinitiation. - In the combined cohort (n = 395), early reinitiation showed a non-significant trend toward higher recurrence versus delayed reinitiation: unadjusted Cox HR 1.348 (95% CI 0.948–1.915; p = 0.096) and logistic OR 1.305 (95% CI 0.797–2.139; p = 0.290). - After adjustment for baseline covariates the trend persisted but did not reach statistical significance (adjusted Cox HR 2.011; 95% CI 0.973–4.158; p = 0.0592). - Univariable Cox analysis identified several patient-level factors associated with recurrence: **female sex** (males HR 0.649), higher **HbA1c** (HR 1.09 per %), and reduced **eGFR** (HR 0.992 per ml/min/1.73 m²). Older age and impaired renal function were also associated in univariable analysis. - Authors conclude early SGLT2i reinitiation may be reasonable in lower-risk patients (men with preserved renal function and lower HbA1c); results are inconclusive for higher-risk patients. - The study is limited by retrospective design and case ascertainment limited to clinically coded encounters with antibiotic prescriptions; randomized trials are needed to define optimal timing. - Ethical approval and waiver of informed consent were obtained; authors reported no competing interests.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. * 2 Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan. * 3 Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. * 4 Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan. * 5 Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan. qwerty1987@cgmh.org.tw. * PMID: **42803855** * DOI: [ 10.1007/s12020-026-04777-3 ](https://doi.org/10.1007/s12020-026-04777-3) Item in Clipboard # Risk factors for recurrent urinary tract infection after SGLT2 inhibitor reinitiation in type 2 diabetes Yu-Chu Hsueh et al. Endocrine. 2026. Show details Display options Display options Format Abstract PubMed PMID Endocrine Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Endocrine%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Endocrine%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) . 2026 Sep 28;91(1):317. doi: 10.1007/s12020-026-04777-3. ### Authors [Yu-Chu Hsueh](https://pubmed.ncbi.nlm.nih.gov/?term=Hsueh+YC&cauthor_id=42803855)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803855/#short-view-affiliation-1 "Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan."), [Chia-Hung Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+CH&cauthor_id=42803855)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803855/#short-view-affiliation-2 "Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42803855/#short-view-affiliation-3 "Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan."), [Pi-Hua Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+PH&cauthor_id=42803855)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803855/#short-view-affiliation-2 "Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42803855/#short-view-affiliation-4 "Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan."), [Yi-Hsuan Lin](https://pubmed.ncbi.nlm.nih.gov/?term=Lin+YH&cauthor_id=42803855)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42803855/#short-view-affiliation-5 "Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan. qwerty1987@cgmh.org.tw.") ### Affiliations * 1 Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. * 2 Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan. * 3 Department of Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan. * 4 Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan. * 5 Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan. qwerty1987@cgmh.org.tw. * PMID: **42803855** * DOI: [ 10.1007/s12020-026-04777-3 ](https://doi.org/10.1007/s12020-026-04777-3) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Purpose:** To determine the risk of recurrent urinary tract infection (UTI) after early reinitiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in adults with type 2 diabetes and to identify patient-level factors associated with recurrence. **Methods:** We conducted a retrospective cohort study. Adults with type 2 diabetes who discontinued an SGLT2i after an index UTI and were subsequently restarted were classified by reinitiation timing (early vs delayed). Recurrent UTI was defined as a new, clinically coded episode following reinitiation. Multivariable models assessed associations between recurrence and demographics, comorbidities, glycemic control, renal function, and psychiatric history. **Results:** Among 316 patients who restarted SGLT2i within 21 days during or after the first UTI episode, recurrent UTI occurred in 43.99% after 14 days post-reinitiation. In the combined cohort (n = 395), early reinitiation ( - [DOI](https://doi.org/10.1056/nejmoa1504720) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/26378978/) 2. 1. S.D. Wiviott, I. Raz, M.P. Bonaca, O. Mosenzon, E.T. Kato, A. Cahn et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N. Engl. J. Med. 380(4), 347–357 (2019). - [DOI](https://doi.org/10.1056/nejmoa1812389) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/30415602/) 3. 1. H.J.L. Heerspink, B.V. Stefansson, R. Correa-Rotter, G.M. Chertow, T. Greene, F.F. Hou et al. Dapagliflozin in patients with chronic kidney disease. N. Engl. J. Med. 383(15), 1436–1446 (2020). - [DOI](https://doi.org/10.1056/nejmoa2024816) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/32970396/) 4. 1. V. Perkovic, M.J. Jardine, B. Neal, S. Bompoint, H.J.L. Heerspink, D.M. Charytan et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N. Engl. J. Med. 380(24), 2295–2306 (2019). - [DOI](https://doi.org/10.1056/nejmoa1811744) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/30990260/) 5. 1. The EMPA-KIDNEY Collaborative Group, W.G. Herrington, N. Staplin, C. Wanner, J.B. Green, S.J. Hauske et al. Empagliflozin in Patients with Chronic Kidney Disease. N. Engl. J. Med. 388(2), 117–127 (2023). - [DOI](https://doi.org/10.1056/nejmoa2204233) Show all 39 references ## MeSH terms * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Diabetes Mellitus, Type 2* / complications Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Diabetes+Mellitus%2C+Type+2%2Fcomplications%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Diabetes+Mellitus%2C+Type+2) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Diabetes Mellitus, Type 2* / drug therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Diabetes+Mellitus%2C+Type+2%2Fdrug+therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Diabetes+Mellitus%2C+Type+2) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Female Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Female%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Female) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Male Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Male%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Male) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Middle Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Middle+Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Middle+Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Recurrence Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Recurrence%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Recurrence) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Retrospective Studies Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Retrospective+Studies%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Retrospective+Studies) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Risk Factors Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Risk+Factors%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Risk+Factors) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Sodium-Glucose Transporter 2 Inhibitors* / adverse effects Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Sodium-Glucose+Transporter+2+Inhibitors%2Fadverse+effects%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Sodium-Glucose+Transporter+2+Inhibitors) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803855/) * Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Sodium-Glucose+Transporter+2+Inhibitors%2Ftherapeutic+use%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/
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