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.

Yaşlı hastalarda SGLT2 inhibitörü kullanımı: laboratuvar değerlendirilmesi

“…Studies have also shown that SGLT2 inhibitors increase hemoglobin and hematocrit values (13,14). Dapagliflozin has been shown to exert this effect by increasing hepcidin levels (15), while empagliflozin has been shown to increase erythropoiesis and increase hemoglobin and hematocrit values (16).…”

“…Total cholesterol was measured by enzymatic colorimetric method and highdensity lipoprotein cholesterol was measured by enzymatic colorimetric method with a Hitachi modular autoanalyzer (Roche Diagnostic Corp., Indianapolis, IN, USA). Lowdensity lipoprotein cholesterol level was calculated with the Friedewald formula for patients with triglyceride levels of <400 mg/dL (14). Patients with triglyceride of >400 mg/ dL were evaluated by enzymatic colorimetric method with the second-generation LDL-C Plus Kit and the Hitachi Modular P800 (Roche Diagnostic Corp., Indianapolis, IN, USA).…”