Noninsulin medication therapy for hospitalized patients with diabetes mellitus
| Autor: | Sarah E. Petite |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
endocrine system diseases medicine.medical_treatment MEDLINE 030209 endocrinology & metabolism Hypoglycemia law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Diabetes mellitus Diabetes Mellitus Humans Hypoglycemic Agents Insulin Medicine 030212 general & internal medicine Intensive care medicine Adverse effect Glycemic Pharmacology Inpatients business.industry Health Policy medicine.disease Hospitalization Observational study business |
| Zdroj: | American Journal of Health-System Pharmacy. 75:1361-1368 |
| ISSN: | 1535-2900 1079-2082 |
| DOI: | 10.2146/ajhp170869 |
| Popis: | Purpose Published evidence regarding the role of noninsulin antidiabetic therapies in glycemic management of hospitalized patients with diabetes mellitus is reviewed. Summary The American Diabetes Association recommends against the routine use of noninsulin antidiabetic therapies during hospitalization and supports insulin use instead. There are significant risks associated with insulin therapy, including hypoglycemia, and use of alternative therapies may be considered in hospitalized patients. A MEDLINE literature search was conducted to find articles on studies evaluating the use of noninsulin antidiabetic therapies in the inpatient setting; all full-text English-language publications presenting observational and randomized clinical trial data on the topic of interest were considered for inclusion in the review, with 9 publications selected for review. The majority of the reviewed research focused on incretin-based therapies, and favorable safety and efficacy outcomes were reported with the use of dipeptidyl peptidase-4 (DPP-4) inhibitors. The available evidence indicates that the use of other noninsulin medications, including glucagon-like peptide-1 receptor agonists and sulfonylureas, to achieve and maintain glycemic control in the inpatient setting may be limited by adverse effects. Conclusion Optimal glycemic control in hospitalized patients with diabetes is necessary to avoid adverse effects. Insulin therapy is currently the primary medication recommended for this patient population. DPP-4 inhibitors have been demonstrated to be safe and effective for use in the inpatient setting in patients with well-controlled diabetes. Further research is needed to help define the role of noninsulin medications in the inpatient setting. |
| Databáze: | OpenAIRE |
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