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RISK FACTORS FOR HYPOGLYCEMIA IN INPATIENTS WITH TOTAL PARENTERAL NUTRITION AND TYPE 2 DIABETES: A POST HOC ANALYSIS OF THE INSUPAR STUDY
- Source :
- ENDOCRINE PRACTICE, r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante, instname, r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
- Publication Year :
- 2020
-
Abstract
- Objective: Treatment of hyperglycemia with insulin is associated with increased risk of hypoglycemia in type 2 diabetes mellitus (T2DM) patients receiving total parenteral nutrition (TPN). The aim of this study was to determine the predictors of hypoglycemia in hospitalized T2DM patients receiving TPN. Methods: Post hoc analysis of the INSUPAR study, which is a prospective, open-label, multicenter clinical trial of adult inpatients with T2DM in a noncritical setting with indication for TPN. Results: The study included 161 patients; 31 patients (19.3%) had hypoglycemic events, but none of them was severe. In univariate analysis, hypoglycemia was significantly associated with the presence of diabetes with end-organ damage, duration of diabetes, use of insulin prior to admission, glycemic variability (GV), belonging to the glargine insulin group in the INSUPAR trial, mean daily grams of lipids in TPN, mean insulin per 10 grams of carbohydrates, duration of TPN, and increase in urea during TPN. Multiple logistic regression analysis showed that the presence of diabetes with end-organ damage, GV, use of glargine insulin, and TPN duration were risk factors for hypoglycemia. Conclusion: The presence of T2DM with end-organ damage complications, longer TPN duration, belonging to the glargine insulin group, and greater GV are factors associated with the risk of hypoglycemia in diabetic noncritically ill inpatients with parenteral nutrition. Abbreviations: ADA = American Diabetes Association; BMI = body mass index; CV% = coefficient of variation; DM = diabetes mellitus; GI = glargine insulin; GV = glycemic variability; ICU = intensive care unit; RI = regular insulin; T2DM = type 2 diabetes mellitus; TPN = total parenteral nutrition.
- Subjects :
- Blood Glucose
medicine.medical_specialty
endocrine system diseases
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
Risk Factors
Diabetes mellitus
Internal medicine
Medicine
Humans
Hypoglycemic Agents
Insulin
030212 general & internal medicine
Prospective Studies
Inpatients
business.industry
Insulin glargine
nutritional and metabolic diseases
Type 2 Diabetes Mellitus
medicine.disease
Parenteral nutrition
Diabetes Mellitus, Type 2
Regular insulin
Parenteral Nutrition, Total
business
medicine.drug
Subjects
Details
- ISSN :
- 1530891X
- Volume :
- 26
- Issue :
- 6
- 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.....978ca0d21345b2140647d4bfa796d6d0