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Dergiler / Geriatrik Bilimler Dergisi / 2026 / Cilt: 9

Sodyum-Glukoz Kotransporter 2 İnhibitörlerinin Tip 2 Diyabetli Türk Yaşlı Bireylerde Bilişsel Fonksiyon Üzerine Etkisi: Kontrollü 26 Haftalık Çalışma

Impact of Sodium-glucose Cotransporter 2 Inhibitors on Cognitive Function in Turkish Older Adults with Type 2 Diabetes: A Controlled 26-Week Study

Elif Parlak(BALIKESİR ÜNİVERSİTESİ, TIP FAKÜLTESİ)0009-0007-4706-4668
Suleyman Emre Kocyıgıt(Balıkesir Üniversitesi)0000-0003-2025-8263
Sayfa
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Yayın Tarihi
2026-09-14
DOI
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Bulgular: Toplam 153 katılımcının ortalama yaşı ve kadın cinsiyet oranı gruplar arasında benzerdi (p>0.05).

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Amaç & Hipotez:Amaç: Sodyum-glukoz kotransporter 2 (SGLT-2) inhibitörleri, tip 2 diyabetes mellitus (T2DM) tedavisinde esas olarak renal ve kardiyovasküler koruma amacıyla kullanılmaktadır.
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Temel Bulgular & Veri:Bu çalışmada, SGLT-2 inhibitörlerinin Türk yaşlı bireylerde bilişsel fonksiyon üzerine etkilerinin 26 haftalık takip süresince değerlendirilmesi amaçlanmıştır.
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Sonuç & Katkı:Bulgular: Toplam 153 katılımcının ortalama yaşı ve kadın cinsiyet oranı gruplar arasında benzerdi (p>0.05).
🔬Tür:Laboratuvar & Saha Deneyi
📍Kapsam:153 birey
⚙️Değişkenler:Bilişsel Fonksiyon · Diyabetes Mellitus · Sodyum-Glukoz Kotransporter 2 Inhibitörü

Özet

Amaç: Sodyum-glukoz kotransporter 2 (SGLT-2) inhibitörleri, tip 2 diyabetes mellitus (T2DM) tedavisinde esas olarak renal ve kardiyovasküler koruma amacıyla kullanılmaktadır. Bu çalışmada, SGLT-2 inhibitörlerinin Türk yaşlı bireylerde bilişsel fonksiyon üzerine etkilerinin 26 haftalık takip süresince değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Prospektif ve kontrollü olarak tasarlanan bu çalışmaya, yaşları ≥60 olan toplam 153 birey dahil edildi. Katılımcıların 72’si SGLT-2 inhibitörü tedavisine yeni başlayan T2DM hastalarından, 81’i ise diyabeti olmayan kontrol grubundan oluştu. Tüm katılımcılara başlangıçta ve 26. haftada kapsamlı geriatri değerlendirmesi, laboratuvar incelemeleri ile bilişsel ve fonksiyonel testler uygulandı. Gruplar arası ve grup içi değişiklikler uygun istatistiksel yöntemler (tekrarlı ölçümler ANOVA ve ANCOVA) ile analiz edildi. Bulgular: Toplam 153 katılımcının ortalama yaşı ve kadın cinsiyet oranı gruplar arasında benzerdi (p>0.05). Ancak, SGLT-2 inhibitörü kullanan grupta vücut kitle indeksi (VKİ) ve komorbidite yükü daha yüksek bulundu (p<0.05). Başlangıçta bilişsel performans, özellikle standardize mini mental durum muayenesi (SMMSE) toplam skorları açısından SGLT-2 grubunda farklılık gösterdi (p<0.05). Yirmi altı haftalık takip sonunda, SGLT-2 grubunda metabolik parametrelerde anlamlı düzelmeler gözlendi. Bununla birlikte, SMMSE’nin kayıt (registration) alt boyutunda düşüş saptandı (p<0.05). Bu düşüş, VKİ, HbA1c ve 25-hidroksi vitamin D değişimleri için düzeltme yapıldığında anlamlılığını kaybetti (p>0.05). Alt grup analizinde, SGLT-2 inhibitörlerini dipeptidil peptidaz-4 (DPP-4) inhibitörleri ile birlikte kullananlarda bilişsel olumlu olarak gözlendi (p<0.05). Sonuç: SGLT-2 inhibitörleri, geriatri pratiğinde Türk yaşlı bireylerde bilişsel açıdan güvenli görünmektedir. Her ne kadar 26 haftalık takipte kayıt alt boyutunda bir gerileme izlense de, glisemik kontrolün sağlanması, uygun kilo yönetimi ve yeterli vitamin D desteği ile bu etkinin ortadan kalktığı görülmüştür.

Abstract

Objective: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors are primarily used for renal and cardiovascular protection in type 2 diabetes mellitus (T2DM). It was aimed to survey the effects of SGLT-2 inhibitors on cognitive function in Turkish older adults at 26 weeks follow-up. Materials and Methods: This prospective, controlled study included 153 participants aged ≥60, comprising 72 type 2 diabetic patients initiating SGLT-2 inhibitors and 81 non-diabetic controls. Comprehensive geriatric assessments, laboratory evaluations, and cognitive and functional tests were conducted at baseline and after 26 weeks. Group comparisons and within-group changes were analyzed using appropriate statistical methods, including repeated measures ANOVA and ANCOVA. Results: Among the 153 participants, the mean age and frequency of female gender were similar between groups (p>0.05), though body mass index (BMI) and comorbidity burden were higher in the SGLT-2 inhibitor group (p<0.05). Cognitive performance, particularly total standardized mini-mental state examination (SMMSE) scores, was significantly different in the SGLT2 inhibitor group at baseline (p<0.05). After 26 weeks, significant improvements in metabolic parameters were observed in the SGLT2 inhibitor group, but the record subdomain of SMMSE declined (p<0.05). This decline lost significance after adjusting for changes in BMI, HbA1c, and 25-hydroxy vitamin D (p>0.05). Subgroup analysis revealed cognitive benefit in those using dipeptidyl peptidase-4 (DPP-4) inhibitors alongside SGLT2 inhibitors (p<0.05). Conclusion: SGLT-2 inhibitors appear to be cognitively safe in older Turkish adults within geriatric clinical practice. Although a decline in registration performance was observed at the 26-week follow-up, this effect was not evident when glycemic control, optimal weight management, and adequate vitamin D supplementation were maintained.

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Bu Makaleye Atıf Yap

Parlak, E., Kocyıgıt, S. E. (2026). Sodyum-Glukoz Kotransporter 2 İnhibitörlerinin Tip 2 Diyabetli Türk Yaşlı Bireylerde Bilişsel Fonksiyon Üzerine Etkisi: Kontrollü 26 Haftalık Çalışma. Geriatrik Bilimler Dergisi, Cilt: 9. https://ajindex.com/articles/1488296

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