Background: Promising results of clinical trials involving SGLT2 inhibitors urge every clinician managing diabetes to use them. However, upcoming real-world data still show increased incidence of adverse events, but efficacy is comparable to clinical trials. Objectives: Genitourinary infection is the most commonly reported adverse effect with SGLT2 inhibitors. We evaluated effectiveness of patient screening protocol and advice of hygiene and hydration to avoid adverse effects of SGLT2 inhibitors in real-world setting. Method: This was a prospective observational longitudinal study which included consecutive subjects with uncontrolled T2DM recommended with SGLT2i after a simple screening protocol from December 2017 to November 2018. The adverse effects and metabolic parameters were evaluated at 1st, 3rd, 6th, and 12th months for each patient. Results: Of 413 patients recommended for SGLT2 inhibitors, 335 patients started the medication. At baseline, average age, glycosylated haemoglobin (HbA1c), and weight were 53 years, 9.5%, and 82 kg, respectively. Data of 332, 299, 270, and 231 patients were available at the 1st, 3rd, 6th, and 12th months for safety follow-up, respectively. Genitourinary tract infection was the most common adverse effect (8%) followed by ketosis (4%). Two patients needed to stop the drug permanently due to recurrent transient ischaemic attack and emphysematous pyelonephritis. Significant reduction in mean weight and HbA1c was observed at 6 months (n = 270): 2.9 kg and 1.1%, respectively, and at 12 months (n = 231): 3.8 kg and 1.6%, respectively. Conclusion: Simple screening protocol for patients considered for SGLT2i significantly reduced incidence of genitourinary adverse events.
Dubai Diabetes Endocrinol J

中文翻译：

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SGLT2抑制剂的实际临床经验：对2型糖尿病患者使用特殊的筛查工具以避免严重的不良事件：单中心前瞻性研究

背景：涉及SGLT2抑制剂的临床试验的有希望的结果敦促每位治疗糖尿病的临床医生都应使用它们。然而，即将到来的现实世界数据仍显示不良事件的发生率有所增加，但疗效与临床试验相当。目的：泌尿生殖道感染是SGLT2抑制剂最常见的不良反应。我们评估了患者筛查方案的有效性以及卫生和补水的建议，以避免在实际环境中SGLT2抑制剂产生不利影响。方法：这是一项前瞻性观察性纵向研究，纳入了从2017年12月至2018年11月经过简单筛查方案后推荐使用SGLT2i推荐的未控制T2DM的连续受试者。在每个患者的第1、3、6和12个月评估了不良反应和代谢参数。结果：在推荐使用SGLT2抑制剂的413位患者中，有335位患者开始用药。在基线时，平均年龄，糖基化血红蛋白（HbA1c）和体重分别为53岁，9.5％和82公斤。在安全性随访的第1、3、6和12个月分别可获得332、299、270和231例患者的数据。泌尿生殖道感染是最常见的不良反应（8％），其次是酮症（4％）。由于反复发作的短暂性脑缺血发作和气肿性肾盂肾炎，两名患者需要永久停用药物。平均体重和HbA1c在6个月（n = 270）：分别为2.9 kg和1.1％；在12个月（n = 231）：分别为3.8 kg和1.6％显着降低。结论：对于考虑使用SGLT2i的患者进行的简单筛查方案可显着降低泌尿生殖泌尿系统不良事件的发生率。
迪拜糖尿病内分泌J