Assessing the use of sodium-glucose cotransporter 2 inhibitor in patients with type 2 diabetes mellitus and chronic kidney disease in tertiary care: a SwissDiab Study.

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Pascale Sharon Hösli, Frida Renström, Markus Laimer, Claudia Cavelti-Weder, Giacomo Gastaldi, Roger Lehmann, Michael Brändle
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Abstract

Introduction: The overall aim of this study was to evaluate the implementation of sodium-glucose cotransporter 2 inhibitors (SGLT2i) among patients in tertiary care with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD).

Research design and methods: The cross-sectional analysis was based on outpatients in tertiary diabetes care enrolled in the Swiss Diabetes Registry with T2DM and a study visit January 1, 2020-March 31, 2021. Prevalence of CKD was ascertained as an estimated glomerular filtration rate <60 mL/min/1.73 m2 and/or persistent albuminuria as defined by Kidney Disease Improving Global Outcomes, and the proportion of patients prescribed SGLT2i was determined. Documented reasons for non-treatment with SGLT2i were extracted by a retrospective review of the medical records.

Results: Of 368 patients with T2DM, 1.1% (n=4) were excluded due to missing data. Of the remaining 364 patients, 47.3% (n=172) had CKD of which 32.6% (n=56) were prescribed SGLT2i. The majority (75%) of these patients were on treatment already in 2018, before the renoprotective effects of SGLT2i were established. Among the 116 patients without SGLT2i, 19.0% had known contraindications, 9.5% stopped treatment due to adverse events, 5.2% had other reasons, and no underlying reason for non-treatment could be identified for 66.4%.

Conclusions: A divergence between recommended standard of care and implementation in daily clinical practice was observed. Although treatment should always consider patient-specific circumstances, the results highlight the need to reinforce current treatment recommendations to ensure patients benefit from the best available care.

评估钠-葡萄糖共转运体 2 抑制剂在三级医疗机构 2 型糖尿病和慢性肾病患者中的使用情况:SwissDiab 研究。
简介本研究的总体目标是评估钠-葡萄糖共转运体 2 抑制剂(SGLT2i)在三级医疗机构 2 型糖尿病(T2DM)和慢性肾病(CKD)患者中的应用情况:横断面分析的对象是在瑞士糖尿病登记处登记的、2020年1月1日至2021年3月31日就诊的2型糖尿病门诊患者。根据 "肾脏病改善全球结果 "的定义,确定CKD患病率为估计肾小球滤过率2和/或持续白蛋白尿,并确定开具SGLT2i处方的患者比例。通过回顾性审查病历,提取了未使用 SGLT2i 治疗的记录原因:在 368 名 T2DM 患者中,1.1%(4 人)因数据缺失而被排除。在剩余的 364 名患者中,47.3%(n=172)患有慢性肾脏病,其中 32.6%(n=56)服用了 SGLT2i。这些患者中的大多数(75%)已于 2018 年接受治疗,当时 SGLT2i 的肾保护作用尚未确立。在未使用SGLT2i的116名患者中,19.0%有已知禁忌症,9.5%因不良事件停止治疗,5.2%有其他原因,66.4%的患者未找到不治疗的根本原因:结论:建议的治疗标准与日常临床实践中的执行情况存在差异。尽管治疗应始终考虑患者的具体情况,但研究结果强调了加强当前治疗建议的必要性,以确保患者从现有的最佳治疗中获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
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