Do SGLT2 inhibitors prevent preclinical diabetic retinopathy? A Prospective Pilot Optical Coherence Tomography Angiography Study Les inhibiteurs du SGLT2 préviennent-ils la rétinopathie diabétique préclinique ? : une étude pilote prospective sur l'angiographie par tomographie par cohérence optique
Journal Francais d'Ophtalmologie, cilt.44, sa.8, ss.1159-1167, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 44 Sayı: 8
- Basım Tarihi: 2021
- Doi Numarası: 10.1016/j.jfo.2021.01.005
- Dergi Adı: Journal Francais d'Ophtalmologie
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
- Sayfa Sayıları: ss.1159-1167
- Anahtar Kelimeler: Diabetes mellitus, Metformin intolerance, Optical coherence tomography angiography, Preclinical diabetic retinopathy, SGLT2 inhibitor
- Bilecik Şeyh Edebali Üniversitesi Adresli: Evet
Özet
Purpose: To evaluate the effects of metformin alone and combined treatment with metformin and an SGLT2 inhibitor on retinal microvascular morphology using optical coherence tomography angiography (OCTA) in isolated type 2 diabetes mellitus (DM) patients with HbA1c above the expected target (> 7%). Methods: Fifty patients with isolated DM, 7% < HbA1c < 8%, without diabetic retinopathy (DR) using 500 mg metformin ×2 for glycemic control were included in the study. OCTA and BMI measurements were obtained at the first evaluation. Treatment was changed to metformin 1000 mg ×2. Patients who did not develop side effects due to the metformin were defined as the metformin-tolerant group (group-1). Patients who developed side effects were defined as the metformin-intolerant group (group-2), and their treatment was changed to metformin 500 mg ×2 and empagliflozin 10 mg. The second evaluation was performed three months after the last treatment change. Results: HbA1c was lower on the second evaluation in both groups (P < 0.001, in both). On the second evaluation in group-1, a decrease was found in superficial perifoveal and deep parafoveal macular vascular plexus densities (P: 0.040 and P: 0.020, respectively). No statistically significant difference was observed in group-2. Conclusion: SGLT2 inhibitors may contribute to preventing the development of preclinical DR. In patients with metformin intolerance, adding SGLT2 inhibitors may be a reasonable choice to protect the retina.