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Fournier Gangrene Alarm: More Cases Linked to Diabetes Drugs

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Northerner

Northerner

Admin (Retired)
Relationship to Diabetes
Type 1
Fournier gangrene (FG), a necrotizing infection of the perineum, is a relatively rare but potentially fatal complication of treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors, new data from the US Food and Drug Administration (FDA) suggest.

The FDA had previously added a warning about FG to the labels of all SGLT2 inhibitors, used to treat type 2 diabetes, in August 2018, based on 12 cases reported from March 2013 to May 2018.

Now, findings from a review of 55 cases reported to the FDA Adverse Event Reporting System (FAERS) through January 2019 have been published onlineMay 6 in Annals of Internal Medicine by Susan J. Bersoff-Matcha, MD, of the FDA's Center for Drug Evaluation and Research, Silver Spring, Maryland, and colleagues.

All of the patients required hospitalization, some needed multiple surgeries, and there were three fatalities.

https://www.medscape.com/viewarticle/912634

Very rare, but worrying :(
 
Association does not prove cause. You don’t get necrotising fasciitis without skin injury. Floxins are added into medication usually because Diabetes can’t be controlled otherwise. High BG feeds infections.

So, wake in the morning with a high BG, scratch your nether regions over enthusiastically, break the skin, add poor hygiene into the mix and away you go.

And as for the gangrene of the toes that they mention, the only drug I know of that can cause that is ergot, a potent vasoconstrictor. Floxins don’t do that. Diabetes does.

Fournier gangrene was identified in 1883 as a complication of diabetes, and is always attributed to perineal or urethral injury. I don’t doubt that the sugary urine may be an aggravating factor, but it isn’t a cause. First identified in men, because it’s about 40 times commoner in men. Past associations are alcoholism, STDs, compromised immunity for reasons other than diabetes, and general hygiene problems. This association with floxins was noted in 2018, to be added to all the others.

The lesson is take care of your nether regions, stay clean and dry and don’t stray. Oh, and position 72 is a no no.
 
The data seems to show that the flesh-eating-horror risk from SGLT2 inhibitors is very low but on the other hand it also seems to show that their glucose lowering effect is also very low. If a doc wanted to prescribe them for me, I would want him/her to be able to answer the question: Why this drug rather than some cheap proven diuretic?
 
Because diuretics only abstract water from the bloodstream. Cheapest diuretic is caffeine, which you may have noticed doesn’t affect your BG one way or the other till you put milk or sugar with it.
 
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