TdC 313: Inibidores de SGLT2 - 6 Clinicagens

Notas do episódio

https://www.tadeclinicagem.com.br/guia/ Confira a promoção especial para o plano anual do Guia TdC: Receba em casa o Card de Consulta Rápida no Plantão, com os temas: IOT, ACLS, ATB, ECG, trombólise e reposição eletrolítica. Receba em casa o porta-crachá (tirante para crachá) do TdC. Ganhe R$ 50 OFF (de 449 por 399,00) 7 primeiros dias inteiramente grátis Use o CUPOM: GUIADZERO 🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨 Chegou o episódio escolhido por vocês! Marcela Belleza e Joanne Alves convidam Carol Millon para conversar sobe 6 clinicagens de inibidores de SGLT2, as gliflozinas: Indicações além do DM Risco de CAD euglicêmica Quando não usar? ⁠Cuidados com doença aguda (sick day) e hipovolemia ⁠Cuidados pré-operatório Risco de fratura e amputação Referências: 1. Bailey CJ, et al. Dapagliflozin add-on to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial. BMC Med. 2013;11:43. Published 2013 Feb 20. doi:10.1186/1741-7015-11-43 2. Bersoff-Matcha SJ, et al. Fournier Gangrene Associated With Sodium-Glucose Cotransporter-2 Inhibitors: A Review of Spontaneous Postmarketing Cases. Ann Intern Med. 2019;170(11):764-769. doi:10.7326/M19-0085 3. Chang HY, et al. Association Between Sodium-Glucose Cotransporter 2 Inhibitors and Lower Extremity Amputation Among Patients With Type 2 Diabetes. JAMA Intern Med. 2018;178(9):1190-1198. doi:10.1001/jamainternmed.2018.3034 4. Clar C, et al. Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes. BMJ Open. 2012 Oct 18;2(5):e001007. doi: 10.1136/bmjopen-2012-001007. PMID: 23087012; PMCID: PMC3488745. 5. Das SR, et al. 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2020 Sep 1;76(9):1117-1145. doi: 10.1016/j.jacc.2020.05.037. Epub 2020 Aug 5. PMID: 32771263; PMCID: PMC7545583. 6. Fralick M, et al. Risk of amputation with canagliflozin across categories of age and cardiovascular risk in three US nationwide databases: cohort study. BMJ. 2020;370:m2812. Published 2020 Aug 25. doi:10.1136/bmj.m2812 7. Li D, et al. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2017;19(3):348-355. doi:10.1111/dom.12825 8. Neal B, et al. Rationale, design, and baseline characteristics of the Canagliflozin Cardiovascular Assessment Study (CANVAS)--a randomized placebo-controlled trial. Am Heart J. 2013;166(2):217-223.e11. doi:10.1016/j.ahj.2013.05.007 9. Nyirjesy P, et al. Evaluation of vulvovaginal symptoms and Candida colonization in women with type 2 diabetes mellitus treated with canagliflozin, a sodium glucose co-transporter 2 inhibitor. Curr Med Res Opin. 2012;28(7):1173-1178. doi:10.1185/03007995.2012.697053 10. Perkovic V, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med. 2019;380(24):2295-2306. doi:10.1056/NEJMoa1811744 11. Rosenwasser RF, et al. SGLT-2 inhibitors and their potential in the treatment of diabetes. Diabetes Metab Syndr Obes. 2013 Nov 27;6:453-67. doi: 10.2147/DMSO.S34416. PMID: 24348059; PMCID: PMC3848644. 12. Sridharan K, Sivaramakrishnan G. Risk of limb amputation and bone fractures with sodium glucose cotransporter-2 inhibitors: a network meta-analysis and meta-regression. Expert Opin Drug Saf. 2025;24(7):797-804. doi:10.1080/14740338.2024.2377755 13. Ueda P, et al. Sodium glucose cotransporter 2 inhibitors and risk of serious adverse events: nationwide register based cohort study. BMJ. 2018;363:k4365. Published 2018 Nov 14. doi:10.1136/bmj.k4365 14. Watts NB, et al. Effects of Canagliflozin on Fracture Risk in Patients With Type 2 Diabetes Mellitus. J Clin Endocrinol Metab. 2016 Jan;101(1):157-66. doi: 10.1210/jc.2015-3167. Epub 2015 Nov 18. PMID: 26580237; PMCID: PMC4701850. 15. Zhuo M, et al. Association of Sodium-Glucose Cotransporter-2 Inhibitors With Fracture Risk in Older Adults With Type 2 Diabetes. JAMA Netw Open. 2021;4(10):e2130762. Published 2021 Oct 1. doi:10.1001/jamanetworkopen.2021.30762 16. Emerson Cestari Marino, Leandra Anália Freitas Negretto, Rogério Silicani Ribeiro, Denise Momesso, Alina Coutinho Rodrigues Feitosa, Marcos Tadashi Kakitani Toyoshima, Joaquim Custódio da Silva Junior, Sérgio Vencio, Marcio Weissheimer Lauria, João Roberto de Sá, Domingos A. Malerbi, Fernando Valente, Silmara A. O. Leite, Danillo Ewerton Oliveira Amaral, Gabriel Magalhães Nunes Guimarães, Plínio da Cunha Leal, Maristela Bueno Lopes, Luiz Carlos Bastos Salles, Liana Maria Torres de Araújo Azi, Amanda Gomes Fonseca, Lorena Ibiapina M. Carvalho, Francília Faloni Coelho, Bruno Halpern, Cynthia M. Valerio, Fabio R. Trujilho, Antonio Carlos Aguiar Brandão, Ruy Lyra e Marcello Bertoluci. Rastreamento e Controle da Hiperglicemia no Perioperatório – Posicionamento Conjunto da Sociedade Brasileira de Diabetes (SBD), Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira para o Estudo da Obesidade e Síndrome Metabólica (ABESO). Diretriz Oficial da Sociedade Brasileira de Diabetes (2025). DOI: 10.29327/5660187.2025-10 , ISBN: 978-65-5941-367-6. 17. Singh LG, Ntelis S, Siddiqui T, Seliger SL, Sorkin JD, Spanakis EK. Association of Continued Use of SGLT2 Inhibitors From the Ambulatory to Inpatient Setting With Hospital Outcomes in Patients With Diabetes: A Nationwide Cohort Study. Diabetes Care. 2024;47(6):933-940. doi:10.2337/dc23-1129 18. Mehta PB, Robinson A, Burkhardt D, Rushakoff RJ. Inpatient Perioperative Euglycemic Diabetic Ketoacidosis Due to Sodium-Glucose Cotransporter-2 Inhibitors - Lessons From a Case Series and Strategies to Decrease Incidence. Endocr Pract. 2022;28(9):884-888. doi:10.1016/j.eprac.2022.06.006 19. Umapathysivam MM, Morgan B, Inglis JM, et al. SGLT2 Inhibitor-Associated Ketoacidosis vs Type 1 Diabetes-Associated Ketoacidosis. JAMA Netw Open. 2024;7(3):e242744. Published 2024 Mar 4. doi:10.1001/jamanetworkopen.2024.2744 20. Fleming N, Hamblin PS, Story D, Ekinci EI. Evolving Evidence of Diabetic Ketoacidosis in Patients Taking Sodium-Glucose Cotransporter 2 Inhibitors. J Clin Endocrinol Metab. 2020;105(8):dgaa200. doi:10.1210/clinem/dgaa200 21. Neuen BL, Young T, Heerspink HJL, et al. SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2019;7(11):845-854. doi:10.1016/S2213-8587(19)30256-6 22. Braunwald E. Gliflozins in the Management of Cardiovascular Disease. N Engl J Med. 2022;386(21):2024-2034. doi:10.1056/NEJMra2115011 23. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-2128. doi:10.1056/NEJMoa1504720 24. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377(7):644-657. doi:10.1056/NEJMoa1611925 25. Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380(4):347-357. doi:10.1056/NEJMoa1812389 26. McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995-2008. doi:10.1056/NEJMoa1911303 27. Packer M, Anker SD, Butler J, et al. Cardiovascu...