Introduction: Glycosuric effect of SGLT2i is often complicated by Genito-urinary tract infection (GUTI). Despite all measures (hydration, hygiene, and healthy toilet habits) the risk is still 4-9%. Withdrawing SGLT2i from treatment deprives patient of its multiple benefits. On the contrary, frequent antibiotics and antifungal use emerges risk of drug resistance. Cranberry contain fungistatic benzoic acid and proanthocyanidins which inhibit the adherence of p-fimbriae of E.Coli.
Aim and Objective: This study was designed to observe the preventive effect of cranberry extract for recurrent GUTI due to SGLT2i use in T2DM.
Methods: One hundred and three subjects having T2DM, using SGLT2i as OHA were selected as cases. Cases were prescribed cranberry extract 300mg BD for 6 months. Comparators were also 98, age and sex-matched subjects having T2DM and using SGLT2i. Comparators were not prescribed cranberry extract. Subjects with uncontrolled glycemic targets and other risk factors for recurrent GUTI were excluded. Both groups were followed for 6 months and periodically evaluated for symptomatic and/or pathologically proven UTI using standard definition.
Result: Nine out of 103 cases and, 6 out of 98 comparators were excluded from observation either due to loss to follow-up, poor compliance, or getting complicated UTI leading to permanent drug withdrawal. Average incidence of GUTI among 94 cases (M=1.9, SD=1.4) matched to 92 comparators (M=2.6, SD=1.8), demonstrated significantly lesser frequency, z=-2.21, u=3510.5 and p=.027. No demonstratable or significant side effect due to cranberry extract was reported during the observation period. Average HbA1c reduction after observation period among cases (M=-0.3) compared with comparators (M=0.2) didn’t demonstrated significant difference (z=-1.84, p=.06). Cranberry extract didn’t show any effect over glycemic values.
Conclusion: Cranberry extract when used as an add-on to SGLT2i demonstrated a significant reduction in the incidence of GUTI.
A. Gautam: None. P. K. Agrawal: None. N. Pursnani: None. P. K. Maheshwari: None. R. Rani: None.