Fournier's gangrene in patients with type 2 diabetes using second-line antidiabetic medications

Diabetes Obes Metab. 2020 Feb;22(2):267-271. doi: 10.1111/dom.13886. Epub 2019 Oct 13.


Cases of a rare but serious infection called Fournier's gangrene have been reported with sodium-glucose co-transporter-2 inhibitors (SGLT-2i). To evaluate the safety signal in a population of patients with type 2 diabetes, we used administrative claims data from Horizon Blue Cross Blue Shield of New Jersey from 2014 through 2017 to estimate incidence rates of Fournier's gangrene or necrotizing fasciitis of the perineum among patients treated with a second-line antidiabetic drug. We found very low incidence rates of Fournier's gangrene or necrotizing fasciitis. While we found no indication of an increased risk among SGLT-2i users compared with similar patients treated with other second-line antidiabetic medications, the small number of events yielded wide confidence intervals.

Keywords: cohort study; database research; observational study; pharmaco-epidemiology; sodium-glucose co-transporter-2 inhibitor; type 2 diabetes.

Publication types

  • Observational Study

MeSH terms

  • Administrative Claims, Healthcare / statistics & numerical data
  • Aged
  • Cardiovascular Diseases / epidemiology
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Fasciitis, Necrotizing / epidemiology
  • Female
  • Fournier Gangrene / chemically induced
  • Fournier Gangrene / epidemiology*
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypoglycemic Agents / classification
  • Hypoglycemic Agents / therapeutic use
  • Incidence
  • Male
  • Prevalence
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*
  • United States / epidemiology


  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors