{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:34:37Z","timestamp":1753893277790,"version":"3.41.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> The recent report issued by the MHRA indicating an association of Sodium glucose linked transporter type 2 (SGLT2) Inhibitors with the contraction of Fournier's Gangrene (FG), has been drawn with insufficient supporting evidence and without an adequately powered study to make any meaningful assertions or recommendations. We aimed to look specifically at the currently available dataset used to link SGLT2 Inhibitors to FG and highlight what conclusions or inferences can meaningfully be made, in particular the power of any study that would be required to make sensible conclusions.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> World literature review of SGLT2 Inhibitors and FG was performed. With a subsequent 10-year review of cases of FG seen in a regional burns and plastics centre. Data was collected retrospectively from the coding department at Whiston Hospital for all patients with necrotising fasciitis. An electronic document management system was used to identify patients with FG specifically as well as their diabetes state and medication history.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Seventy-eight patients were admitted with FG, of whom 32 had diabetes mellitus (DM). Of those with DM none was taking an SGLT2 Inhibitor, 17 patients were taking metformin, a further nine patients were taking a second line medication and 14 required insulin injections.<\/jats:p><jats:p><jats:bold>Discussions:<\/jats:bold> DM is a known major risk factor for FG, which is clearly observed in our patient cohort. The risk of patients with DM developing FG is irrespective of the medication patients are taking. The current articles and reports published have little ground to claim an association between SGLT2 Inhibitors and FG and are missing the crucial message that needs to be conveyed to the public: that DM is a major risk factor for FG and patients suffering with diabetes need to be extra vigilant.<\/jats:p>","DOI":"10.3389\/fsurg.2021.754101","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T04:35:42Z","timestamp":1639110942000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Perspectives From a Regional Plastic Surgery Centre on Evidence for the Purported Link Between SGLT2 Inhibitors and Fournier's Gangrene"],"prefix":"10.3389","volume":"8","author":[{"given":"Luke","family":"Taylor","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar","family":"Asmar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anirban","family":"Mandal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ascanio","family":"Tridente","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Hardy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayvan","family":"Shokrollahi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/j.diabres.2014.02.014","article-title":"SGLT2 inhibitors in the treatment of type 2 diabetes","volume":"104","author":"Hasan","year":"2014","journal-title":"Diabetes Res Clin Pract."},{"key":"B2","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1177\/1479164114561992","article-title":"Probing SGLT2 as a therapeutic target for diabetes: basic physiology and consequences","volume":"12","author":"Gallo","year":"2015","journal-title":"Diabetes Vasc Dis Res."},{"key":"B3","unstructured":"2019"},{"key":"B4","unstructured":"2019"},{"key":"B5","unstructured":"2019"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1056\/NEJMoa1515920","article-title":"Empagliflozin and progression of kidney disease in type 2 diabetes","volume":"375","author":"Wanner","year":"2016","journal-title":"N Engl J Med."},{"key":"B8","unstructured":"2018"},{"key":"B9","unstructured":""},{"key":"B10","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1128\/CMR.00076-09","article-title":"Candida infections of the genitourinary tract","volume":"23","author":"Achkar","year":"2010","journal-title":"Clin Microbiol Rev."},{"key":"B11","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s00125-006-0570-3","article-title":"Influence of diabetes and hyperglycaemia on infectious disease hospitalisation and outcome","volume":"50","author":"Benfield","year":"2007","journal-title":"Diabetologia."},{"key":"B12","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1111\/dom.12428","article-title":"Long-term efficacy and safety of canagliflozin over 104 weeks in patients aged 55\u201380 years with type 2 diabetes","volume":"17","author":"Bode","year":"2015","journal-title":"Diabetes Obes Metab."},{"key":"B13","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.diabres.2015.05.044","article-title":"Empagliflozin as add-on to metformin plus sulphonylurea in patients with type 2 diabetes","volume":"110","author":"Haering","year":"2015","journal-title":"Diabetes Res Clin Pract."},{"key":"B14","doi-asserted-by":"publisher","first-page":"740","DOI":"10.2337\/dc13-0467","article-title":"Parikh, S, Study 10 Group. 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