Işılay TAŞKALDIRAN, Şerife Mehlika KUŞKONMAZ, Cavit CULHA

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

Amaç: Yaşlılarda diyabet tedavisi ve takibi daha zor ve hassastır. Sodyum glukoz ko-transporter tip 2 (SGLT2) inhibitörleri yenigeliştirilmiş 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 üstühastalar alındı. Çalışmaya toplam 52 hasta dahil edildi. Çalışma retrospektif dosya tarama olarak dizayn edildi. SGLT2 inhibitörütedavisi 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 değerlerindeistatistiksel olarak anlamlı derecede azalma izlendi. Hastaların üre ve kreatinin değerlerinde tedavi sonrası artış izlenirken, eGFRdeğerinde düşme izlendi. Tedavi sonrası spot idrarda albümin/kreatinin oranında azalma, hemoglobin ve hematokrit değerlerinde artışizlendi. 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) tedavikesilmiştir.Sonuç: 65 yaş üstü tip 2 diyabet hastalarında SGLT 2 inhibitörü tedavisi ile glisemik kontrol başarılıdır, yan etkileri ve ilaç kesilmeoranları kabul edilebilir sınırlardadır

Anahtar Kelimeler:

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

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

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 sideeffects. 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 dapagliflozinin our center were included in the study. A total of 52 patients were included in the study. The study was designed as a retrospective filescan. Before and after SGLT2 inhibitor treatment, biochemical data, drug-related side effects and drug withdrawal information wererecorded.Results: A statistically significant decrease was observed in the fasting blood glucose (FBG), postprandial blood glucose (PPBG), andHbA1c values of the patients after the SGLT2 inhibitor was started. While the urea and creatinine values of the patients increased afterthe treatment, a decrease was observed in the eGFR value. After treatment, a decrease in albumin/creatinine ratio in spot urine and anincrease in hemoglobin and hematocrit values were observed. No complaints were reported in 31 patients (59.6%) and no side effectswere detected. Side effects associated with SGLT2 inhibitor were observed in 21 patients (40.3%). In total, treatment was continued in 41patients (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 effectsand drug withdrawal rates are within acceptable limits.

Keywords:

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

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