SGLT2抑制剂在高龄2型糖尿病患者中的安全性

R. Baeza-Trinidad, J. Mosquera-Lozano
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引用次数: 0

摘要

钠葡萄糖共转运蛋白2抑制剂(SGLT2i)是最新的抗糖尿病治疗方法,可降低死亡率和心血管结局。由于其可能的副作用,它在现实生活中对老年患者的使用受到限制。材料和方法:自2014年以来,我们对我们社区(拉里奥哈)接受SGLT2i治疗的患者进行了回顾性研究。评估治疗前24个月的安全性(不良反应)和预后(死亡率、心脏失代偿和心血管事件)。结果:我们纳入了235例SGLT2i患者,其中男性114例(48.5%),平均年龄79.6±3.9岁。使用最多的SGLT2i是恩格列净(55.7%)。纳入时的平均Hb1Ac为7.9±1.4,随访期间有47.7%的纳入患者Hb1Ac下降。治疗24个月时肌酐和肾小球滤过率的初始值分别为0.94±0.3和68.3±16.4,治疗24个月后分别为0.94±0.27和68.2±15.8。在随访期间,84名患者发生了94起不良事件,53名患者暂停治疗。这些不良事件与性别(p 0.004)、达格列净(p < 0.001)和初始Hb1Ac值(p 0.04)有关。最常见的不良事件是泌尿生殖系统感染(63),其次是急性肾损伤(9),后者是导致治疗中断的最常见原因。随访期间症状性低血糖与胰岛素、年龄、Hb1Ac治疗相关(p <0.01)。结论:在现实生活中,SGLT2i治疗是一种安全且耐受性良好的老年患者治疗方法。泌尿生殖系统感染是最常见的不良事件,但不太常见的不良事件会导致治疗中断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Safety of SGLT2 inhibitors in very elderly diabetic type 2 patients in real life
Introduction: Sodium glucose cotransporter 2 inhibitors (SGLT2i) are the latest antidiabetic treatments that reduces mortality and cardiovascular outcomes. Its use in real life in very elderly patients is limited by its possible side effects. Material and methods: We conducted a retrospective study of patients treated with SGLT2i in our community (La Rioja) since 2014. The safety (adverse effects) and prognosis (mortality, cardiac decompensation, and cardiovascular events) during the first 24 months of treatment were evaluated. Results: We included 235 patients treated with SGLT2i, 114 of them were men (48.5%), and the mean age was 79.6 ± 3.9 years. The most used SGLT2i was empagliflozin (55.7%). The mean Hb1Ac at the time of inclusion was 7.9 ± 1.4, showing a decrease in 47.7% of the included patients during the follow up. The initial values of creatinine and glomerular filtration rate at the time of inclusion (0.94 ± 0.3 and 68.3 ± 16.4) presented an improvement at 24 months of treatment (0.94 ± 0.27 and 68.2 ± 15.8). During follow-up, 94 adverse events were described in 84 patients, and 53 treatment suspensions. This adverse events were related with sex (p 0.004), dapagliflozin (p < 0.001) and initial Hb1Ac values (p 0.04). The most common adverse event were genitourinary infections (63), followed by acute kidney injury (9), being the latter the most frequent cause of treatment interruption. Symptomatic hypoglycaemia during the follow-up was related with treatment of insulin, age and Hb1Ac (p <0.01). Conclusions: Treatment with SGLT2i is a safe and well-tolerated treatment in very elderly patients in real life. Genitourinary infections are the most common adverse events, but those that less frequently cause treatment interruption.
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