Metformin is the most commonly used drug for the treatment of type 2 diabetes (T2D), which is dramatically increasing due to factors such as increasing obesity, physical inactivity, and aging of the population. Metformin analysis was carried out in composite wastewater samples seasonally collected from wastewater treatment plants in 10 cities in 2019 and 2020 30 cities in 2021 in Turkiye. Metformin was measured in all wastewater samples, with an average concentration of 97.81 μg/l in 2019, 75.19 μg/l in 2020, and 69.13 μg/l in 2021. This study was utilized to predict metformin usage in different sociodemographic regions in Turkiye using a wastewater-based epidemiology (WBE) approach. As a result of the analysis, the average metformin consumption in Turkiye was estimated to be 22.2 ± 9.6 [1.9–63.8] g/d/1,000 persons (mean ± SD [range]). Furthermore, these estimates were compared with data for time, sociodemographic characteristics, and patient numbers. Assessing the correlation with estimates and the socioeconomic classes of the cities in question revealed that cities with high-income levels had the lowest metformin use rate. Finally, the study provides supporting data aiding the development of public health strategies for decreasing the overall load of T2D across Turkiye.

中文翻译：

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利用基于废水的流行病学估算土耳其抗糖尿病药物二甲双胍的用量

二甲双胍是治疗 2 型糖尿病 (T2D) 最常用的药物，由于肥胖增加、缺乏身体活动和人口老龄化等因素，该病的发病率正在急剧增加。对土耳其 2019 年 10 个城市和 2020 年 2021 年 30 个城市的废水处理厂季节性采集的复合废水样品进行了二甲双胍分析。所有废水样品中均检测到二甲双胍，2019 年平均浓度为 97.81 μg/l，2020 年为 75.19 μg/l，2021 年为 69.13 μg/l。本研究用于预测土耳其不同社会人口区域的二甲双胍使用情况基于废水的流行病学（WBE）方法。分析结果显示，土耳其二甲双胍的平均消费量估计为 22.2 ± 9.6 [1.9–63.8] g/d/1,000 人（平均值 ± SD [范围]）。此外，还将这些估计值与时间、社会人口统计特征和患者数量的数据进行了比较。评估相关城市的估计值和社会经济阶层的相关性表明，高收入城市的二甲双胍使用率最低。最后，该研究提供了支持数据，有助于制定公共卫生战略，以减少土耳其各地 T2D 的总体负担。