Evaluation of Dipeptidyl Peptidase-IV Inhibitor Use in Hospitalized Patients With Diabetes
| Autor: | Sarah E. Petite, Maja C. Hill |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Blood Glucose medicine.medical_specialty Hospitalized patients 030209 endocrinology & metabolism Dipeptidyl peptidase Cohort Studies 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal medicine medicine Humans Hypoglycemic Agents Insulin Pharmacology (medical) 030212 general & internal medicine Dipeptidyl-Peptidases and Tripeptidyl-Peptidases Glycemic Glycated Hemoglobin Dipeptidyl-Peptidase IV Inhibitors business.industry Optimal treatment Type 2 Diabetes Mellitus medicine.disease Clinical Practice Clinical research Diabetes Mellitus Type 2 business |
| Zdroj: | Annals of Pharmacotherapy. 55:1326-1332 |
| ISSN: | 1542-6270 1060-0280 |
| DOI: | 10.1177/1060028021996337 |
| Popis: | Background: Glycemic control within goal blood glucose (BG) ranges is essential to minimize hospital complications for patients with type 2 diabetes mellitus (T2DM). Optimal treatment in the non–intensive care unit (ICU) setting includes a basal insulin containing regimen. Dipeptidyl peptidase-IV (DPP-IV) inhibitors have minimal hypoglycemia incidence and may be an appropriate bolus insulin replacement in the inpatient setting. Objective: To determine the effect of basal insulin plus DPP-IV inhibitor compared with basal plus bolus insulin in hospitalized patients with T2DM. Methods: This multicenter cohort study included adult patients with T2DM admitted to the non-ICU setting and prescribed either basal insulin plus DPP-IV inhibitor or basal plus bolus insulin. Propensity-score matching was performed for age, sex, Charlson Comorbidity Index, first BG reading during hospitalization, and hemoglobin A1C (A1C). The primary outcome was the difference in mean daily BG during hospitalization. Secondary outcomes included hospital length of stay (LOS), total daily dose (TDD) of insulin, hypoglycemic events, and mean daily BG in patients with an A1C >8%. Results: A total of 105 patients were included in each group. Mean daily BG during hospitalization was lower in the basal insulin plus DPP-IV inhibitor group (199.3 ± 52.5 vs 213.6 ± 45.8 mg/dL; P = 0.04). There was a significant difference in hospital LOS (5 [interquartile range = 3-8] vs 6 [4-11] days; P = 0.02) and short-acting insulin TDD (11.6 ± 9.1 vs 20.5 ± 21.2 units; P < 0.001). No differences were observed in basal insulin TDD and hypoglycemia. There was no difference in mean daily BG in the subgroup analysis of patients with a A1C >8%. Conclusions and Relevance: A significant difference in mean daily BG and hospital LOS was found with a basal insulin plus DPP-IV inhibitor regimen. Use of a DPP-IV inhibitor to replace bolus insulin in hospitalized patients with T2DM should be considered. |
| Databáze: | OpenAIRE |
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