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José Esteban Costa Gil,1 Juan Carlos Garnica Cuéllar,2 Paula Perez Terns,3 Aldo Ferreira-Hermosillo,4 José Antonio Cetina Canto,5 Ángel Alfonso Garduño Perez,2 Pedro Mendoza Martínez,6 Lucas Rista,7 Alejandro Sosa-Caballero,6 Estefanía Vázquez-Mendez,8 Luis Fernando Tejado Gallegos,8 Hungta Chen,9 Agustina Elizalde,10 Virginia B Tomatis10 1Departamento de Endocrinología, Instituto de Cardiología La Plata, La Plata, Buenos Aires, Argentina; 2Departamento de Endocrinología del Centro Médico Nacional “ 20 de Noviembre”, ISSSTE, Ciudad de México, México; 3Dirección Médica, Cardiología Palermo - Centro de Investigaciones Clínicas, Buenos Aires, Argentina; 4Unidad de Investigación Médica en Enfermedades Endócrinas. Centro Médico Nacional Siglo XXI, IMSS, Ciudad de México, México; 5Hospital Regional ISSSTE, Mérida, Yucatán estado, México; 6Endocrinología, Hospital Angeles Lindavista, Ciudad de México, México; 7Diabetes, Innovación e Investigación, Centro de Diabetes y Nutrición - Investigaciones Clínicas (CEDyN), Rosario, Santa Fé, Argentina; 8Medical Affairs, AstraZeneca - México, Ciudad de México, México; 9Global Medical & Payer Evidence Statistics, AstraZeneca, Gaithersburg, Maryland, USA; 10Medical Affairs, AstraZeneca – South Cone, Buenos Aires, ArgentinaCorrespondence: José Esteban Costa Gil, Costa Gil Departamento de Endocrinología, Instituto de Cardiología La Plata, Calle 6, número 212, La Plata, 1900, Buenos Aires, Argentina, Tel +54 9 2214 20-7359, Email jecostagil@hotmail.comPurpose: Despite newer type 2 diabetes (T2D) medications, patients do not always achieve metabolic targets, remaining at risk for cardiorenal complications. Therapeutic decisions are generally made by the healthcare team without considering patients’ preferences. We aimed to evaluate patients’ T2D treatment preference in two Latin-American countries between two different oral medication profiles, one resembling dipeptidyl peptidase-4 inhibitors (DPP4i) and another resembling sodium-glucose cotransporter-2 inhibitors (SGLT2i).Patients and Methods: In this cross-sectional, multicenter study from June to September 2020, patients with T2D from Argentina and Mexico (n = 390) completed a discrete choice experiment questionnaire to identify preferences between DPP4i (medication profile A) and SGLT2i (medication profile B). The reason behind patients’ choice, and the association between their baseline characteristics and their preference were evaluated using logistic regression methods.Results: Most participants (88.2%) preferred SGLT2i’s profile. Participants with older age (p = 0.0346), overweight or obesity (p < 0.0001), high blood pressure (BP; p < 0.0001), high total cholesterol (p = 0.0360), and glycosylated hemoglobin (HbA1c) < 7% (p = 0.0001) were more likely to choose SGLT2i compared with DPP4i’s profile. The most and least important reasons to choose either drug profile were HbA1c reduction and genital infection risk, respectively. The likelihood of selecting the SGLT2i’s profile significantly increased in participants with increased body mass index (BMI; odds ratio [OR] = 8.9, 95% confidence interval [CI]: 3.5– 22.5, p < 0.05), high BP (OR = 4.9, 95% CI: 1.9– 12.4, p < 0.05), and lower education level (OR = 3.6, 95% CI: 1.0– 12.6, p < 0.05).Conclusion: Latin-American patients with T2D preferred medication with a profile resembling SGLT2i over one resembling DPP4i as a treatment option. A patient-centered approach may aid the healthcare team in decision-making for improved outcomes.Keywords: dipeptidyl peptidase-4 inhibitors, patient preference, sodium-glucose cotransporter-2 inhibitors, type 2 diabetes

Background: Continuous glucose monitoring can improve glycemic control for hospitalized patients with diabetes, according to current evidence. However, there is a lack of consensus-established recommendations for the management of hospitalized patients with diabetes using flash continuous glucose monitoring system (fCGM) in Latin America. Therefore, this expert consensus exercise aimed to establish guidelines on the implementation of fCGM in the management of hospitalized patients with diabetes in Latin America., Methods: The modified Delphi method was applied on a panel of nine specialists, establishing consensus at 80%. A twenty-two-question instrument was developed to establish recommendations on the use of fCGM in hospitalized patients living with diabetes., Results: Based on consensus, experts recommend the use of fCGM in hospitalized patients with diabetes starting at admission or whenever hyperglycemia (> 180 mg/dl) is confirmed and continue monitoring throughout the entire hospital stay. The recommended frequency of fCGM scans varies depending on the patient's age and diabetes type: ten scans per day for pediatric patients with type 1 and 2 diabetes, adult patients with type 1 diabetes and pregnant patients, and seven scans for adult patients with type 2 diabetes. Different hospital services can benefit from fCGM, including the emergency room, internal medicine departments, intensive care units, surgery rooms, and surgery wards., Conclusions: The use of fCGM is recommended for patients with diabetes starting at the time of admission in hospitals in Latin America, whenever the necessary resources (devices, education, personnel) are available., (© 2024. The Author(s).)

Although in recent years in Mexico the quality of diabetes mellitus (DM) care has improved and access to health services and medications has increased, there is a lack of adherence to the recommendations of the clinical guidelines, which could explain the poor glycemic control in many of the patients with DM. Sodium-glucose cotransporter type 2 (iSGLT2) inhibitors have been the last class of antidiabetic agents to receive approval from the Food and Drug Administration (FDA) and COFEPRIS (Mexico). In order to improve the use of SGLT2i in clinical practice in Mexico, this paper presents the recommendations issued by a panel of eleven Mexican experts based on the new published evidence for the treatment of patients with DM2.