Reasons for Discontinuing Treatment with Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Diabetes in Real-World Settings: The KAMOGAWA-A Study
Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are a class of antidiabetic agents known to exert cardioprotective, renoprotective, and hypoglycemic effects. However, these agents have been associated with adverse effects, such as genital infection, volume depletion, hypoglycemia, and diabetic k...
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creator | Saijo, Yuto Okada, Hiroshi Hata, Shinnosuke Nakajima, Hanako Kitagawa, Nobuko Okamura, Takuro Osaka, Takafumi Kitagawa, Noriyuki Majima, Saori Senmaru, Takafumi Ushigome, Emi Nakanishi, Naoko Hamaguchi, Masahide Fukui, Michiaki |
description | Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are a class of antidiabetic agents known to exert cardioprotective, renoprotective, and hypoglycemic effects. However, these agents have been associated with adverse effects, such as genital infection, volume depletion, hypoglycemia, and diabetic ketoacidosis, resulting in drug discontinuation. Herein, we aimed to determine the reasons for discontinuing treatment with SGLT2is among Japanese patients with diabetes. This retrospective cohort study enrolled 766 patients with diabetes who had initiated SGLT2is between January 2014 and September 2021. The follow-up period was 2 years from the initiation of the SGLT2is. Overall, 97 patients (12.7%) discontinued the SGLT2is during the follow-up period. The most common reasons for discontinuing the SGLT2is were frequent urination (19.6%), followed by genital infection (11.3%), improved glycemic control (10.6%), and renal dysfunction (8.2%). A comparison of the characteristics between the continuation and the discontinuation group was conducted, excluding those who discontinued the SGLT2is because of improved glycemic control. The patients in the discontinuation group (68 [55–75] years) were older than those in the continuation group (64 [53–71] years; p = 0.003). Importantly, we found no significant association between diabetes duration, diabetic control, renal function, or complications of diabetes in both groups. This real-world study revealed that frequent urination was the most common reason underlying SGLT2i discontinuation among Japanese patients with diabetes. To avoid discontinuation, precautions against various factors that may cause frequent urination must be implemented. |
doi_str_mv | 10.3390/jcm12226993 |
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However, these agents have been associated with adverse effects, such as genital infection, volume depletion, hypoglycemia, and diabetic ketoacidosis, resulting in drug discontinuation. Herein, we aimed to determine the reasons for discontinuing treatment with SGLT2is among Japanese patients with diabetes. This retrospective cohort study enrolled 766 patients with diabetes who had initiated SGLT2is between January 2014 and September 2021. The follow-up period was 2 years from the initiation of the SGLT2is. Overall, 97 patients (12.7%) discontinued the SGLT2is during the follow-up period. The most common reasons for discontinuing the SGLT2is were frequent urination (19.6%), followed by genital infection (11.3%), improved glycemic control (10.6%), and renal dysfunction (8.2%). A comparison of the characteristics between the continuation and the discontinuation group was conducted, excluding those who discontinued the SGLT2is because of improved glycemic control. The patients in the discontinuation group (68 [55–75] years) were older than those in the continuation group (64 [53–71] years; p = 0.003). Importantly, we found no significant association between diabetes duration, diabetic control, renal function, or complications of diabetes in both groups. This real-world study revealed that frequent urination was the most common reason underlying SGLT2i discontinuation among Japanese patients with diabetes. To avoid discontinuation, precautions against various factors that may cause frequent urination must be implemented.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm12226993</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Body mass index ; Cardiovascular disease ; Clinical medicine ; Cohort analysis ; Complications and side effects ; Dapagliflozin ; Dextrose ; Diabetes ; Diabetes therapy ; Diabetic ketoacidosis ; Diabetic neuropathy ; Diabetic retinopathy ; Dosage and administration ; Glucose ; Hypoglycemic agents ; Insulin ; Kidney diseases ; Medical research ; Medicine, Experimental ; Sodium ; Type 2 diabetes ; Urinalysis ; Urinary tract diseases ; Urinary tract infections ; Urination ; Urogenital system ; Vein & artery diseases</subject><ispartof>Journal of clinical medicine, 2023-11, Vol.12 (22), p.6993</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-1e2897f7b27805e8c00560d176cc1653f6e081db7063150b2f0b6aec0c7d8abd3</citedby><cites>FETCH-LOGICAL-c398t-1e2897f7b27805e8c00560d176cc1653f6e081db7063150b2f0b6aec0c7d8abd3</cites><orcidid>0000-0001-7269-1697 ; 0000-0002-1707-970X ; 0000-0002-8651-4445 ; 0000-0003-0903-1797 ; 0000-0002-2025-2518 ; 0000-0001-8703-5254 ; 0000-0002-3209-1790 ; 0000-0003-1031-4380 ; 0000-0003-3263-9469 ; 0000-0002-2923-413X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Saijo, Yuto</creatorcontrib><creatorcontrib>Okada, Hiroshi</creatorcontrib><creatorcontrib>Hata, Shinnosuke</creatorcontrib><creatorcontrib>Nakajima, Hanako</creatorcontrib><creatorcontrib>Kitagawa, Nobuko</creatorcontrib><creatorcontrib>Okamura, Takuro</creatorcontrib><creatorcontrib>Osaka, Takafumi</creatorcontrib><creatorcontrib>Kitagawa, Noriyuki</creatorcontrib><creatorcontrib>Majima, Saori</creatorcontrib><creatorcontrib>Senmaru, Takafumi</creatorcontrib><creatorcontrib>Ushigome, Emi</creatorcontrib><creatorcontrib>Nakanishi, Naoko</creatorcontrib><creatorcontrib>Hamaguchi, Masahide</creatorcontrib><creatorcontrib>Fukui, Michiaki</creatorcontrib><title>Reasons for Discontinuing Treatment with Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Diabetes in Real-World Settings: The KAMOGAWA-A Study</title><title>Journal of clinical medicine</title><description>Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are a class of antidiabetic agents known to exert cardioprotective, renoprotective, and hypoglycemic effects. However, these agents have been associated with adverse effects, such as genital infection, volume depletion, hypoglycemia, and diabetic ketoacidosis, resulting in drug discontinuation. Herein, we aimed to determine the reasons for discontinuing treatment with SGLT2is among Japanese patients with diabetes. This retrospective cohort study enrolled 766 patients with diabetes who had initiated SGLT2is between January 2014 and September 2021. The follow-up period was 2 years from the initiation of the SGLT2is. Overall, 97 patients (12.7%) discontinued the SGLT2is during the follow-up period. The most common reasons for discontinuing the SGLT2is were frequent urination (19.6%), followed by genital infection (11.3%), improved glycemic control (10.6%), and renal dysfunction (8.2%). A comparison of the characteristics between the continuation and the discontinuation group was conducted, excluding those who discontinued the SGLT2is because of improved glycemic control. The patients in the discontinuation group (68 [55–75] years) were older than those in the continuation group (64 [53–71] years; p = 0.003). Importantly, we found no significant association between diabetes duration, diabetic control, renal function, or complications of diabetes in both groups. This real-world study revealed that frequent urination was the most common reason underlying SGLT2i discontinuation among Japanese patients with diabetes. To avoid discontinuation, precautions against various factors that may cause frequent urination must be implemented.</description><subject>Body mass index</subject><subject>Cardiovascular disease</subject><subject>Clinical medicine</subject><subject>Cohort analysis</subject><subject>Complications and side effects</subject><subject>Dapagliflozin</subject><subject>Dextrose</subject><subject>Diabetes</subject><subject>Diabetes therapy</subject><subject>Diabetic ketoacidosis</subject><subject>Diabetic neuropathy</subject><subject>Diabetic retinopathy</subject><subject>Dosage and administration</subject><subject>Glucose</subject><subject>Hypoglycemic agents</subject><subject>Insulin</subject><subject>Kidney diseases</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Sodium</subject><subject>Type 2 diabetes</subject><subject>Urinalysis</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urination</subject><subject>Urogenital system</subject><subject>Vein & artery diseases</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptkt9q2zAUxs1YoSXr1V5AsJvBcKY_tiXvziRbVtrS0qT00sjycaJgS5kkU_IofdspzaDtqHQhIf2-74hPJ0k-EzxlrMTft2oglNKiLNmH5IxizlPMBPv4an-anHu_xXEIkVHCz5KnO5DeGo8669Bce2VN0GbUZo1WDmQYwAT0qMMGLW2rxyFd9KOyHtDMBieN31kXwCGKLsxGNzpY55E26FYGHZX-KJ1r2UCA55tYr08frOtbtIQQa639D7TaALqsrm8W1UOVVmgZxnb_KTnpZO_h_N86Se5__VzNfqdXN4uLWXWVKlaKkBKgouQdbygXOAehMM4L3BJeKEWKnHUFYEHahuOCkRw3tMNNIUFhxVshm5ZNkq9H352zf0bwoR5iDND30oAdfR3tY3J5JkREv_yHbu3oTHzdM4ULUWbshVrLHmptukNS6mBaV5xnjBKRlZGavkPF2cKg4y9Ap-P5G8G3o0A5672Drt45PUi3rwmuDw1Qv2oA9heiCaHS</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Saijo, Yuto</creator><creator>Okada, Hiroshi</creator><creator>Hata, Shinnosuke</creator><creator>Nakajima, Hanako</creator><creator>Kitagawa, Nobuko</creator><creator>Okamura, Takuro</creator><creator>Osaka, Takafumi</creator><creator>Kitagawa, Noriyuki</creator><creator>Majima, Saori</creator><creator>Senmaru, Takafumi</creator><creator>Ushigome, Emi</creator><creator>Nakanishi, Naoko</creator><creator>Hamaguchi, Masahide</creator><creator>Fukui, Michiaki</creator><general>MDPI AG</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7269-1697</orcidid><orcidid>https://orcid.org/0000-0002-1707-970X</orcidid><orcidid>https://orcid.org/0000-0002-8651-4445</orcidid><orcidid>https://orcid.org/0000-0003-0903-1797</orcidid><orcidid>https://orcid.org/0000-0002-2025-2518</orcidid><orcidid>https://orcid.org/0000-0001-8703-5254</orcidid><orcidid>https://orcid.org/0000-0002-3209-1790</orcidid><orcidid>https://orcid.org/0000-0003-1031-4380</orcidid><orcidid>https://orcid.org/0000-0003-3263-9469</orcidid><orcidid>https://orcid.org/0000-0002-2923-413X</orcidid></search><sort><creationdate>20231101</creationdate><title>Reasons for Discontinuing Treatment with Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Diabetes in Real-World Settings: The KAMOGAWA-A Study</title><author>Saijo, Yuto ; Okada, Hiroshi ; Hata, Shinnosuke ; Nakajima, Hanako ; Kitagawa, Nobuko ; Okamura, Takuro ; Osaka, Takafumi ; Kitagawa, Noriyuki ; Majima, Saori ; Senmaru, Takafumi ; Ushigome, Emi ; Nakanishi, Naoko ; Hamaguchi, Masahide ; Fukui, Michiaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-1e2897f7b27805e8c00560d176cc1653f6e081db7063150b2f0b6aec0c7d8abd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Body mass index</topic><topic>Cardiovascular disease</topic><topic>Clinical medicine</topic><topic>Cohort analysis</topic><topic>Complications and side effects</topic><topic>Dapagliflozin</topic><topic>Dextrose</topic><topic>Diabetes</topic><topic>Diabetes therapy</topic><topic>Diabetic ketoacidosis</topic><topic>Diabetic neuropathy</topic><topic>Diabetic retinopathy</topic><topic>Dosage and administration</topic><topic>Glucose</topic><topic>Hypoglycemic agents</topic><topic>Insulin</topic><topic>Kidney diseases</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Sodium</topic><topic>Type 2 diabetes</topic><topic>Urinalysis</topic><topic>Urinary tract diseases</topic><topic>Urinary tract infections</topic><topic>Urination</topic><topic>Urogenital system</topic><topic>Vein & artery diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Saijo, Yuto</creatorcontrib><creatorcontrib>Okada, Hiroshi</creatorcontrib><creatorcontrib>Hata, Shinnosuke</creatorcontrib><creatorcontrib>Nakajima, Hanako</creatorcontrib><creatorcontrib>Kitagawa, Nobuko</creatorcontrib><creatorcontrib>Okamura, Takuro</creatorcontrib><creatorcontrib>Osaka, Takafumi</creatorcontrib><creatorcontrib>Kitagawa, Noriyuki</creatorcontrib><creatorcontrib>Majima, Saori</creatorcontrib><creatorcontrib>Senmaru, Takafumi</creatorcontrib><creatorcontrib>Ushigome, Emi</creatorcontrib><creatorcontrib>Nakanishi, Naoko</creatorcontrib><creatorcontrib>Hamaguchi, Masahide</creatorcontrib><creatorcontrib>Fukui, Michiaki</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Saijo, Yuto</au><au>Okada, Hiroshi</au><au>Hata, Shinnosuke</au><au>Nakajima, Hanako</au><au>Kitagawa, Nobuko</au><au>Okamura, Takuro</au><au>Osaka, Takafumi</au><au>Kitagawa, Noriyuki</au><au>Majima, Saori</au><au>Senmaru, Takafumi</au><au>Ushigome, Emi</au><au>Nakanishi, Naoko</au><au>Hamaguchi, Masahide</au><au>Fukui, Michiaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reasons for Discontinuing Treatment with Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Diabetes in Real-World Settings: The KAMOGAWA-A Study</atitle><jtitle>Journal of clinical medicine</jtitle><date>2023-11-01</date><risdate>2023</risdate><volume>12</volume><issue>22</issue><spage>6993</spage><pages>6993-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are a class of antidiabetic agents known to exert cardioprotective, renoprotective, and hypoglycemic effects. However, these agents have been associated with adverse effects, such as genital infection, volume depletion, hypoglycemia, and diabetic ketoacidosis, resulting in drug discontinuation. Herein, we aimed to determine the reasons for discontinuing treatment with SGLT2is among Japanese patients with diabetes. This retrospective cohort study enrolled 766 patients with diabetes who had initiated SGLT2is between January 2014 and September 2021. The follow-up period was 2 years from the initiation of the SGLT2is. Overall, 97 patients (12.7%) discontinued the SGLT2is during the follow-up period. The most common reasons for discontinuing the SGLT2is were frequent urination (19.6%), followed by genital infection (11.3%), improved glycemic control (10.6%), and renal dysfunction (8.2%). A comparison of the characteristics between the continuation and the discontinuation group was conducted, excluding those who discontinued the SGLT2is because of improved glycemic control. The patients in the discontinuation group (68 [55–75] years) were older than those in the continuation group (64 [53–71] years; p = 0.003). Importantly, we found no significant association between diabetes duration, diabetic control, renal function, or complications of diabetes in both groups. This real-world study revealed that frequent urination was the most common reason underlying SGLT2i discontinuation among Japanese patients with diabetes. 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subjects | Body mass index Cardiovascular disease Clinical medicine Cohort analysis Complications and side effects Dapagliflozin Dextrose Diabetes Diabetes therapy Diabetic ketoacidosis Diabetic neuropathy Diabetic retinopathy Dosage and administration Glucose Hypoglycemic agents Insulin Kidney diseases Medical research Medicine, Experimental Sodium Type 2 diabetes Urinalysis Urinary tract diseases Urinary tract infections Urination Urogenital system Vein & artery diseases |
title | Reasons for Discontinuing Treatment with Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Diabetes in Real-World Settings: The KAMOGAWA-A Study |
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