Glucosuria as a Biomarker of Adherence to Sodium-Glucose Co-Transporter Protein Type 2 Inhibitors.
Adherence to treatment with sodium-glucose co-transporter protein type 2 inhibitors (SGLT2i) is essential for the successful treatment of type 2 diabetes. As SGLT2i induce glucosuria, the main study objective was to assess the potential relationship between glucosuria level and adherence to SGLT2i.
The study used electronic health records of patients aged ≥45 years old that had urinalysis data. Glucosuria was classified as absent/normal (0 mg/dL), intermediate (1-1000 mg/dL), and evident (>1000 mg/dL). Renal function, expressed by estimated glomerular filtration rate and stage of chronic kidney disease (CKD), was also assessed. Adherence to SGLT2i was measured with the proportion of days covered in 6 months.
Only 9.2% of samples showed evident glucosuria; of these, 87.5% belonged to patients treated with SGLT2i. Among these patients, glucosuria was mostly evident (78.9%). Absent glucosuria was more common in patients with CKD and in advanced KDIGO stages; therefore, in these patients glucosuria as adherence marker should be interpreted with caution.In patients treated with SGLT2i, absent glucosuria was detected in 4.5% of samples from patients with good adherence, 18.5% of samples from patients with intermediate adherence, and up to 38.5% of samples from patients with poor adherence (p <0.01). Absent glucosuria was also associated with higher blood uric acid level and lower hemoglobin and hematocrit. Absent glucosuria was more common in women and older patients.
Absent glucosuria could be an easy biomarker of poor adherence in patients treated with SGLT2i in clinical practice.
The study used electronic health records of patients aged ≥45 years old that had urinalysis data. Glucosuria was classified as absent/normal (0 mg/dL), intermediate (1-1000 mg/dL), and evident (>1000 mg/dL). Renal function, expressed by estimated glomerular filtration rate and stage of chronic kidney disease (CKD), was also assessed. Adherence to SGLT2i was measured with the proportion of days covered in 6 months.
Only 9.2% of samples showed evident glucosuria; of these, 87.5% belonged to patients treated with SGLT2i. Among these patients, glucosuria was mostly evident (78.9%). Absent glucosuria was more common in patients with CKD and in advanced KDIGO stages; therefore, in these patients glucosuria as adherence marker should be interpreted with caution.In patients treated with SGLT2i, absent glucosuria was detected in 4.5% of samples from patients with good adherence, 18.5% of samples from patients with intermediate adherence, and up to 38.5% of samples from patients with poor adherence (p <0.01). Absent glucosuria was also associated with higher blood uric acid level and lower hemoglobin and hematocrit. Absent glucosuria was more common in women and older patients.
Absent glucosuria could be an easy biomarker of poor adherence in patients treated with SGLT2i in clinical practice.
Authors
Escribano-Serrano Escribano-Serrano, Jiménez-Varo Jiménez-Varo, Escribano-Cobalea Escribano-Cobalea, Casto-Jarillo Casto-Jarillo, López-Ceres López-Ceres, Campos-Dávila Campos-Dávila, Hormigo-Pozo Hormigo-Pozo, Franch-Nadal Franch-Nadal, Michán-Doña Michán-Doña
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