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Função Renal em Idosos com Diabetes Mellitus Tipo 2: Influência dos Inibidores de SGLT-2
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Advisor(s)
Abstract(s)
A diabetes mellitus é uma das principais doenças metabólicas, com uma prevalência de,
aproximadamente, 10% da população mundial. A sua forma mais prevalente é a diabetes
mellitus tipo 2, representado cerca de 90% dos pacientes com diabetes. Atualmente,
quase metade dos indivíduos com diabetes mellitus têm uma idade igual ou superior a
65 anos.
A doença renal diabética afeta 20% a 40% dos diabéticos e é a causa mais comum de
insuficiência renal nestes doentes.
Atualmente, as orientações americanas e europeias recomendam os inibidores do
cotransportador de sódio-glicose tipo 2 (iSGLT-2) como fármaco nefroprotetor e
cardioprotetor. Esta classe farmacológica atua a nível renal inibindo a reabsorção da
glicose filtrada, promovendo a natriurese e glicosúria, sendo este o mecanismo de ação
que está na base dos efeitos nefroprotetores dos iSGLT-2. Embora os iSGLT-2 possuam
indicações formais para todas as faixas etárias, a sua utilização em pacientes idosos ainda
é limitada por diversas barreiras. Uma das principais limitações refere-se à subrepresentação desta população nos ensaios clínicos, o que contribui para a escassez de
dados sobre a segurança e os efeitos adversos desses fármacos em indivíduos com
múltiplas comorbilidades, condição frequentemente observada em idosos.
Mais evidência científica é necessária acerca dos efeitos dos iSGLT-2 neste grupo etário,
na tentativa de melhor compreender as vantagens e limitações terapêuticas associadas à
multimorbilidade destes pacientes.
Esta monografia tem como principais objetivos:
1. Contextualizar a importância dos iSGLT-2 nos pacientes idosos com diabetes
mellitus tipo 2.
2. Esclarecer a interação dos iSGLT-2 e a função renal nos pacientes idosos com
diabetes mellitus tipo 2.
3. Analisar a relação entre a diabetes mellitus tipo 2 e os doentes idosos.
Para a pesquisa bibliográfica foram selecionados artigos de revisão, publicados nos
últimos 5 anos, através das bases de dados “PubMed” e “Scopus”, utilizando os seguintes
termos de pesquisa: “SGLT2 inhibitor” AND “kidney” AND “older”, “SGLT2 inhibitor”
AND “Complications” AND “older”, “SGLT2 inhibitor” AND “older”, “SGLT2 inhibitor”
AND “elderly”, “SGLT2 inhibitor” AND “frailty.”
Diabetes mellitus is one of the main metabolic diseases, affecting approximately 10% of the global population. Its most prevalent form is type 2 diabetes mellitus, accounting for approximately 90% of diabetes cases. Currently, nearly half of individuals with diabetes mellitus are aged 65 years or older. Diabetic kidney disease affects 20% to 40% of individuals with diabetes and represents the leading cause of renal failure in this population. Currently, American and European guidelines recommend sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors) as nephroprotective drugs. This pharmacological class acts at the renal level by inhibiting the reabsorption of filtered glucose, promoting natriuresis and glucosuria, which form the basis of the nephroprotective effects of SGLT-2 inhibitors. Although SGLT-2 inhibitors have formal indications across all age groups, their use in elderly patients remains limited due to several barriers. One of the main limitations relates to the underrepresentation of this population in clinical trials, which contributes to a lack of data regarding the safety and adverse effects of these drugs in individuals with multiple comorbidities, a condition frequently observed in older adults. More scientific evidence is needed regarding the effects of SGLT-2 inhibitors in this age group to better understand the therapeutic advantages and limitations associated with the multimorbidity of these patients. The main objectives of this monograph are: 1. To contextualize the importance of SGLT-2 inhibitors in older patients with type 2 diabetes mellitus. 2. To clarify the interaction between iSGLT-2 and renal function in elderly patients with type 2 diabetes mellitus. 3. To analyze the relationship between type 2 diabetes mellitus and elderly patients. For the literature review, articles published in the last five years were selected from the "PubMed" and "Scopus" databases, using the following search terms: “SGLT2 inhibitor” AND “kidney” AND “older”, “SGLT2 inhibitor” AND “Complications” AND “older”, “SGLT2 inhibitor” AND “older”, “SGLT2 inhibitor” AND “elderly”, “SGLT2 inhibitor” AND “frailty.”
Diabetes mellitus is one of the main metabolic diseases, affecting approximately 10% of the global population. Its most prevalent form is type 2 diabetes mellitus, accounting for approximately 90% of diabetes cases. Currently, nearly half of individuals with diabetes mellitus are aged 65 years or older. Diabetic kidney disease affects 20% to 40% of individuals with diabetes and represents the leading cause of renal failure in this population. Currently, American and European guidelines recommend sodium-glucose cotransporter 2 inhibitors (SGLT-2 inhibitors) as nephroprotective drugs. This pharmacological class acts at the renal level by inhibiting the reabsorption of filtered glucose, promoting natriuresis and glucosuria, which form the basis of the nephroprotective effects of SGLT-2 inhibitors. Although SGLT-2 inhibitors have formal indications across all age groups, their use in elderly patients remains limited due to several barriers. One of the main limitations relates to the underrepresentation of this population in clinical trials, which contributes to a lack of data regarding the safety and adverse effects of these drugs in individuals with multiple comorbidities, a condition frequently observed in older adults. More scientific evidence is needed regarding the effects of SGLT-2 inhibitors in this age group to better understand the therapeutic advantages and limitations associated with the multimorbidity of these patients. The main objectives of this monograph are: 1. To contextualize the importance of SGLT-2 inhibitors in older patients with type 2 diabetes mellitus. 2. To clarify the interaction between iSGLT-2 and renal function in elderly patients with type 2 diabetes mellitus. 3. To analyze the relationship between type 2 diabetes mellitus and elderly patients. For the literature review, articles published in the last five years were selected from the "PubMed" and "Scopus" databases, using the following search terms: “SGLT2 inhibitor” AND “kidney” AND “older”, “SGLT2 inhibitor” AND “Complications” AND “older”, “SGLT2 inhibitor” AND “older”, “SGLT2 inhibitor” AND “elderly”, “SGLT2 inhibitor” AND “frailty.”
Description
Keywords
Diabetes Mellitus Tipo 2 Função Renal Idoso Inibidores do Cotransportador Sódio-Glicose Tipo 2 Tratamento