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SAFETY AND EFFICACY OF DDP4-INHIBITORS FOR MANAGEMENT OF HOSPITALIZED GENERAL MEDICINE AND SURGERY PATIENTS WITH TYPE 2 DIABETES
- Source :
- Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.
- Publication Year :
- 2020
-
Abstract
- DPP-4 inhibitors (DPP-4i) have been shown to be effective for the management of inpatient diabetes. We report pooled data from 3 prospective studies using DPP-4i in general medicine and surgery patients with type 2 diabetes (T2D).We combined data from 3 randomized studies comparing DPP-4i alone or in combination with basal insulin or a basal-bolus insulin regimen. Medicine (n = 266) and surgery (n = 319) patients admitted with a blood glucose (BG) between 140 and 400 mg/dL, treated with diet, oral agents, or low-dose insulin therapy were included. Patients received DPP-4i alone (n = 144), DPP-4i plus basal insulin (n = 158) or basal-bolus regimen (n = 283). All groups received correctional doses with rapid-acting insulin for BG140 mg/dL. The primary endpoint was differences in mean daily BG between groups. Secondary endpoints included differences in hypoglycemia and hospital complications.There were no differences in mean hospital daily BG among patients treated with DPP-4i alone (170 ± 37 mg/dL), DPP-4i plus basal (172 ± 42 mg/dL), or basalbolus (172 ± 43 mg/dL), P = .94; or in the percentage of BG readings within target of 70 to 180 mg/dL (63 ± 32%, 60 ± 31%, and 64 ± 28%, respectively; P = .42). There were no differences in length of stay or complications, but hypoglycemia was less common with DPP-4i alone (2%) compared to DPP-4i plus basal (9%) and basal-bolus (10%); P = .004.Treatment with DPP-4i alone or in combination with basal insulin is effective and results in a lower incidence of hypoglycemia compared to a basal-bolus insulin regimen in general medicine and surgery patients with T2D.BG = blood glucose; BMI = body mass index; CI = confidence interval; DPP-4i = dipeptidyl peptidase-4 inhibitors; HbA1c = hemoglobin A1c; OR = odds ratio; T2D = type 2 diabetes.
- Subjects :
- Blood Glucose
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Insulin Glargine
030209 endocrinology & metabolism
Type 2 diabetes
Hypoglycemia
03 medical and health sciences
0302 clinical medicine
Endocrinology
Diabetes mellitus
medicine
Humans
Hypoglycemic Agents
Insulin
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Dipeptidyl-Peptidase IV Inhibitors
Insulin glargine
business.industry
medicine.disease
Surgery
Regimen
Diabetes Mellitus, Type 2
Basal (medicine)
Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 1530891X
- Database :
- OpenAIRE
- Journal :
- Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
- Accession number :
- edsair.doi.dedup.....42ee4dc28b5dfcfd3f15072e84f7431d