Geriatrik Popülasyonda Sodyum Glukoz Ko-Transporter 2 İnhibitörü(SGLT2i) Kullanımı

Abstract

Amaç: Yaşlılarda diyabet tedavisi ve takibi daha zor ve hassastır. Sodyum glukoz ko-transporter tip 2 (SGLT2) inhibitörleri yeni
geliştirilmiş antidiyabetik ajanlardır. Geriatrik yaş grubunda, SGLT2 inhibitörlerinin kullanımı yan etkileri açısından daha riskli olabilir.
Biz SGLT2 inhibitörlerinin geriatrik yaş grubunda kullanılmasının hastalardaki etkinliğini ve tolerabilitesini değerlendirmeyi planladık.

Gereç ve Yöntemler: Çalışmaya, merkezimizde tip 2 DM tanısı ile empagliflozin veya dapagliflozin tedavisi başlanmış 65 yaş üstü
hastalar alındı. Çalışmaya toplam 52 hasta dahil edildi. Çalışma retrospektif dosya tarama olarak dizayn edildi. SGLT2 inhibitörü
tedavisi öncesi ve sonrası biyokimyasal veriler ve ilaca bağlı yan etkiler ve ilaç kesilme bilgileri kaydedildi.

Bulgular: Hastaların SGLT2 inhibitörü başlandıktan sonra açlık kan şekeri (AKŞ), tokluk kan şekeri (TKŞ), ve HbA1c değerlerinde
istatistiksel olarak anlamlı derecede azalma izlendi. Hastaların üre ve kreatinin değerlerinde tedavi sonrası artış izlenirken, eGFR
değerinde düşme izlendi. Tedavi sonrası spot idrarda albümin/kreatinin oranında azalma, hemoglobin ve hematokrit değerlerinde artış
izlendi. 31 hastada (%59,6) hiçbir şikâyet bildirilmemiş ve yan etki saptanmamıştır. 21 hastada (%40,3) SGLT2 inhibitörü ile ilişkili olduğu düşünülen yan etkiler izlenmiştir. Toplamda 52 hastadan 41 hastada (%78,8) tedaviye devam edilirken, 11 hastada (%21,2) tedavi
kesilmiştir.

Sonuç: 65 yaş üstü tip 2 diyabet hastalarında SGLT 2 inhibitörü tedavisi ile glisemik kontrol başarılıdır, yan etkileri ve ilaç kesilme
oranları kabul edilebilir sınırlardadır

Keywords

• Yaşlı
• diyabetes mellitus
• SGLT2 inhibitörü
• Elderly
• diabetes mellitus
• SGLT2 inhibitor

Use of Sodium Glucose Co-Transporter 2 Inhibitor (SGLT2i) in Geriatric Population

Abstract

Aim: Diabetes treatment and follow-up is more difficult and sensitive in the elderly. Sodium glucose co-transporter type 2 (SGLT2)
inhibitors are newly developed antidiabetic agents. In the geriatric age group, the use of SGLT2 inhibitors may be riskier in terms of side
effects. We planned to evaluate the effect and tolerability of using SGLT2 inhibitors in geriatric patients.
Material and Methods: Patients over 65 years of age with a diagnosis of type 2 DM who were started on empagliflozin or dapagliflozin
in our center were included in the study. A total of 52 patients were included in the study. The study was designed as a retrospective file
scan. Before and after SGLT2 inhibitor treatment, biochemical data, drug-related side effects and drug withdrawal information were
recorded.
Results: A statistically significant decrease was observed in the fasting blood glucose (FBG), postprandial blood glucose (PPBG), and
HbA1c values of the patients after the SGLT2 inhibitor was started. While the urea and creatinine values of the patients increased after
the treatment, a decrease was observed in the eGFR value. After treatment, a decrease in albumin/creatinine ratio in spot urine and an
increase in hemoglobin and hematocrit values were observed. No complaints were reported in 31 patients (59.6%) and no side effects
were detected. Side effects associated with SGLT2 inhibitor were observed in 21 patients (40.3%). In total, treatment was continued in 41
patients (78.8%) out of 52 patients, while treatment was discontinued in 11 patients (21.2%).
Conclusion: In type 2 DM population over 65 years of age, glycemic control with SGLT 2 inhibitor treatment is successful, side effects
and drug withdrawal rates are within acceptable limits.

Keywords

• Elderly
• Diabetes mellitus
• SGLT2 inhibitor
• Elderly, Diabetes mellitus, SGLT2 inhibitor

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