Who told you to prescribe dapagliflozin tablets like this? This is adding fuel to the fire

In the corridors of the hospital, a tense atmosphere began to fill the air. Director Li of the Department of Cardiology, he is taking a group of doctors and interns to carry out daily ward rounds.

• "Attention, today we are going to focus on a 45-year-old female diabetic patient. Director Li's voice sounded in the team, and the doctors immediately cheered up.

• Entering the ward, Director Li's eyes quickly locked on the patient's bedside table, where there was a prescription slip. He picked up the list, his brow furrowed, and his gaze swept over every word.
• "Who prescribed this?" Director Li's voice suddenly raised an octave, and the air in the entire ward seemed to freeze. The little nurses bowed their heads nervously, and the doctors were also shocked.
• "Dapagliflozin tablets, for patients with type 2 diabetes and complicated urinary tract infections?" Director Li's tone was obviously displeased, "This is just nonsense"
• The doctors looked at each other and secretly complained in their hearts.
• "Although dapagliflozin is a potent SGLT2 inhibitor, it can increase the risk of urinary tract infections, especially in the case of complicated urinary tract infections, and using it is tantamount to adding fuel to the fire!" Director Li's words were like a hammer, hitting every doctor's heart.
• "As doctors, every medication decision is a matter of health and safety for our patients. This kind of low-level mistake, I don't want to see it a second time" Director Li's voice echoed in the ward, and every word was full of seriousness and responsibility.
• "Immediately discontinue dapagliflozin and switch to other types of oral hypoglycemic drugs. Director Li issued a new directive, and the doctors immediately took action and began to re-examine the patient's treatment plan.

During the daily ward rounds of the hospital's cardiology department, Director Li severely criticized a 45-year-old female patient with type 2 diabetes and complicated urinary tract infection for medication. Regarding the prescription containing dapagliflozin tablets, Director Li's warning was not groundless, but based on an in-depth understanding of the characteristics of diabetes treatment drugs and the actual situation of patients.

Dapagliflozin: Hypoglycemic nova should also be used with caution

Dapagliflozin, as a sodium-glucose cotransporter 2 (SGLT2) inhibitor, its core mechanism of action is to inhibit the reabsorption of glucose by the kidneys, prompting more glucose to be excreted in the urine, thereby achieving the effect of lowering blood glucose. However, it is this unique hypoglycemic pathway that increases the concentration of glucose in the urine during the use of dapagliflozin, which virtually provides a rich source of nutrients for bacteria, which greatly increases the incidence of urinary tract infections, especially for patients with pre-existing complicated urinary tract infections, and the continued use of such drugs is undoubtedly a risk of aggravating the condition.

So, why do some doctors choose dapagliflozin for diabetes? This is because, in addition to the significant hypoglycemic effect, dapagliflozin also has many benefits such as improving cardiometabolic markers, weight loss, and reducing the risk of cardiovascular events. But when dealing with specific patients, especially if complications are present, we must weigh the potential harms they may bring.

Therefore, Director Li emphasized that doctors should adopt individualized and precise treatment strategies for each patient, especially diabetic patients with complicated urinary tract infections. When choosing oral hypoglycemic drugs, it is necessary to fully consider the safety and applicability of the drugs, so as to avoid ignoring the possible side effects and complications risk due to the simple pursuit of blood glucose control.

Type 2 diabetes: a chronic condition that requires comprehensive management

Type 2 diabetes is a chronic metabolic disease characterized by insulin resistance and relative inadequate insulin secretion, resulting in elevated blood sugar levels. The disease requires lifelong management, including dietary control, moderate exercise, medication, and regular monitoring of blood sugar.

Key points of treatment:

1. - Diet management is the foundation, and a diet low in sugar, fat, and fiber can help control blood sugar.
2. - Moderate exercise can improve insulin sensitivity and help lower blood sugar.
3. - Medication should be based on the patient's specific situation, and the treatment regimen should be adjusted regularly.
4. - Monitor your blood sugar regularly so you can adjust your treatment plan in a timely manner.

Complicated urinary tract infections: complications that cannot be ignored

Complicated urinary tract infections (UTIs) refer to urinary tract infections with factors that increase the risk of treatment failure, such as anatomical abnormalities of the urinary system, stones, and indwelling catheters. This infection is often more difficult to treat than a common urinary tract infection and requires more aggressive anti-infective treatment and symptomatic management.

Key points of treatment:

1. - Prompt antibiotic treatment, choosing the appropriate antibiotic based on culture and drug susceptibility testing.
2. - Treatment of complications of urinary tract infections, such as removal of obstruction and removal of urinary catheters.
3. - Long-term management to prevent the recurrence of urinary tract infections.

Returning to the situation of Director Li's ward rounds, his severe criticism is not only a wake-up call to doctors, but also a reflection of responsibility to patients.

Safe medication and individualized treatment are important principles to protect patients' health. When prescribing medications, doctors should fully consider the overall condition of the patient and avoid unnecessary risks. Patients should also actively cooperate with the doctor's treatment, understand the effects of the drug and possible side effects, and manage their health together.