Table 4.
Association between treatment with SGLT2 inhibitors versus two or more non-SGLT2i AHAs or insulin alone and hospitalization for Fournier’s gangrene among patients with type 2 diabetes
| Primary analysis | ||||
|---|---|---|---|---|
| Treatmenta | Cases (N = 216) | Controls (N = 1296) | Unadjusted OR (95% CI) | Adjusted OR (95% CI)b |
| SGLT2i (with or without other AHAs) | 9 (4.17%) | 100 (7.72%) | 0.42 (0.20–0.88) | 0.55 (0.25–1.18) |
| Two or more non-SGLT2i AHAs or insulin alone | 97 (44.91%) | 474 (36.57%) | 1.0 (reference) | |
| Subgroup analysis: male patients | ||||
|---|---|---|---|---|
| Treatmenta | Cases (N = 201) | Controls (N = 1206) | Unadjusted OR (95% CI) | Adjusted OR (95% CI)b |
| SGLT2i (with or without other AHAs) | 8 (3.98%) | 85 (7.05%) | 0.46 (0.21–0.99) | 0.63 (0.28–1.42) |
| Two or more non-SGLT2i AHAs or insulin alone | 89 (44.28%) | 447 (37.06%) | 1.0 (reference) | |
| Sensitivity analysis: without 30-day grace period to define current AHA use | ||||
|---|---|---|---|---|
| Treatmenta | Cases (N = 216) | Controls (N = 1296) | Unadjusted OR (95% CI) | Adjusted OR (95% CI)b |
| SGLT2i (with or without other AHAs) | 7 (3.24%) | 81 (6.25%) | 0.43 (0.19–0.97) | 0.56 (0.24–1.32) |
| Two or more non-SGLT2i AHAs or insulin alone | 80 (37.04%) | 406 (31.33%) | 1.0 (reference) | |
| Sensitivity analysis: FG identified by ICD-10-CM only among male patients | ||||
|---|---|---|---|---|
| Treatmenta | Cases (N = 122) | Controls (N = 732) | Unadjusted OR (95% CI) | Adjusted OR (95% CI)b |
| SGLT2i (with or without other AHAs) | 7 (5.74%) | 70 (9.56%) | 0.55 (0.24–1.29) | 0.84 (0.35–2.02) |
| Two or more non-SGLT2i AHAs or insulin alone | 46 (37.70%) | 257 (35.11%) | 1.0 (reference) | |
| Sensitivity analysis: SGLT2i with other AHAs vs. two or more non-SGLT2i AHAs | ||||
|---|---|---|---|---|
| Treatmenta | Cases (N = 216) | Controls (N = 1296) | Unadjusted OR (95% CI) | Adjusted OR (95% CI)b |
| SGLT2i with other AHAs | 7 (3.24%) | 94 (7.25%) | 0.48 (0.21–1.11) | 0.48 (0.20–1.14) |
| Two or more non-SGLT2i AHAs | 59 (27.31%) | 411 (31.71%) | 1.0 (reference) | |
aAs defined in “Methods”
bMatched on age, sex, and cohort entry date. Adjusted for baseline insulin use, Charlson comorbidity index (CCI), prior hospitalization, number of non-diabetic medications, and pre-existing comorbidities including obesity, congestive heart failure, diabetic neuropathy, diabetic retinopathy, peripheral artery disease, and moderate to severe renal impairment