Retrospecti̇ve evaluati̇on of the effect of di̇fferent treatment regi̇mens on mean platelet volume, platelet/lymphocyte rati̇o and neutrophi̇l/lymphocyte rati̇o i̇n pati̇ents di̇agnosed wi̇th di̇abetes melli̇tus

Objective: Oral antidiabetics and subcutaneous insulin treatment options are available in the treatment of diabetes, and sodium glucose co-transporter-2 (SGLT-2) inhibitors are widely used. SGLT-2 inhibitors (gluoretics; glyphosines) decrease the glucose reabsorption from the kidney and increase urinary tract glucose excretion by causing SGLT-2 inhibition in the renal proximal tubule. It has positive effects on congestive heart failure, coronary artery disease and diabetic nephropathy. Recently, Average platelet volume (MPV) and neutrophil / lymphocyte ratio (NLO) and platelet / lymphocyte ratio (TLO) are of interest as new inflammatory markers and independent cardiovascular risk factors. In this study we aimed to show whether there is a difference in the effect of SGLT-2 inhibitors on the inflammatory parameters of combined use with oral and diabetic drugs and insulin. Results: A total of 120 cases including 64 women and 56 men with Type 2 DM were included in the study. The patients were evaluated as 4 groups. 30 patients were included in each group. Group 1: Patients who used only non-SGLT-2 oral antidiabetic for at least 3 months, Group 2: Patients who used non-SGLT-2 inhibitor oral antidiabetic and insulin, Group 3: Patients who used SGLT-2 inhibitor drug and oral antidiabetic, Group 4: Patients who use SGLT-2 inhibitor and insulin. The average age of women (56.22 ± 8.75) was calculated as the average age of men (57.84 ± 9.47 years) and no significant difference was found between them (p = 0.44). The mean duration of diabetes was 9 ± 5 years in the first group, 6 ± 6 years in the second group, 10 ± 6 years in the third group and 9 ± 7 years in the 4th group. In the initial comparison of the 4 groups, no significant difference was observed in MPV (p = 0.194), NLO (p = 0.065), TLO (p = 0.272). MPV (p = 0.001), NLO (p = 0.458), TLO (p = 0.052) were found in the comparison of the 4 groups after at least 3 months of treatment. Only MPV value was significantly lower in the 4th group. Also, NLO, TLO and MPV values were compared before and after the treatment of each group. While no significant difference was observed in the first 3 groups (p> 0.05), MPV value was significantly lower in the 4th group (p = 0.001). Conclusion: In our study, in the 4th group using SGLT-2 inhibitor and insulin, a significant decrease was observed in the comparison of MPV value with both the baseline value and the post-treatment values of other groups (p = 0.001). SGLT-2 inhibitor and insulin were thought to reduce cardiovascular risk by reducing inflammation. Keywords: SGLT-2 inhibitor, Type 2 Diabetes Mellitus, MPV, NLO, TLO