Estudo de revisão sobre a interferência de hipoglicemiantes orais no exame químico de urina

Abstract

Diabetes mellitus (DM) is a disease that has been increasing exponentially in the last years of individuals'life and an option for pharmacological treatment is through oral hypoglycemic agents (OH). Because they are widely used drugs being the urinary the major route of excretion, this treatment can cause variations in the results of urinary parameters. Therefore, this study aims at evaluating the interference caused by the use of hypoglycemic agents in urinalysis. With this aim a bibliographic search was conducted in different databases, selecting relevant scientific articles on the topic: diabetes, laboratory interference and pharmacological treatment. The OH can be classified into three groups according to the mechanism of action: stimulators of insulin by the pancreas, such as sulfonylureas and metiglinidas; insulin sensitizers, such as biguanides, thiazolidinediones and the ones reducing the absorption of carbohydrates, which are the inhibitors of alpha-glucosidase. Urinalysis is a complementary tool in the management of MD due to its low cost and easy collection. The classes of oral hypoglycemic agents identified as potentially interfering in urinalysis were biguanides (metformin) and sulfonylureas (tobultamida, tolazamide, gliclazide, clorpropramida). They interfere on the parameters of density, protein, glucose, ketones, bilirubin, leading to an inappropriate diagnosis and an unsatisfactory treatment, generating an injury to the welfare of the patient.

Fármacos para o tratamento do diabetes mellitus tipo 2: interferência no peso corporal e mecanismos envolvidos

“…Não sendo suficiente a administração de uma substância para o controle glicêmico, o tratamento pode ser feito com a associação de outros antidiabéticos. Ademais, considera-se que os medicamentos são a principal tecnologia empregada no tratamento do diabetes e, por isso, faz-se necessário o monitoramento dos remédios utilizados pelos pacientes, visto que a polifarmacoterapia é prática frequente, principalmente por idosos, o que pode acarretar o uso incorreto de medicamentos e, consequentemente, ocasionar efeitos indesejáveis ou agravar a doença de base [9,10].…”