Considerations for Insulin-Treated Type 2 Diabetes Patients During Hospitalization: A Narrative Review of What We Need to Know in the Age of Second-Generation Basal Insulin Analogs
| Autor: | Sherwin C D'Souza, Davida F. Kruger |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Insulin degludec
medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Review Type 2 diabetes 030204 cardiovascular system & hematology Hypoglycemia Insulin glargine U300 03 medical and health sciences Glycemic control 0302 clinical medicine Diabetes mellitus Internal Medicine medicine Formulary Intensive care medicine Glycemic business.industry Insulin glargine Insulin medicine.disease Clinical guidance Hyperglycemia Transition of care Hospital setting business medicine.drug |
| Zdroj: | Diabetes Therapy |
| ISSN: | 1869-6961 1869-6953 |
| DOI: | 10.1007/s13300-020-00920-z |
| Popis: | With the availability of second-generation basal insulin analogs, insulin degludec (100 and 200 units/ml [degludec]) and insulin glargine 300 units/ml (glargine U300), clinicians now have long-acting, efficacious treatment options with stable pharmacokinetic profiles and associated low risks of hypoglycemia that may be desirable for many patients with type 2 diabetes. In this narrative review, we summarize the current evidence on glycemic control in hospitalized patients and review the pharmacokinetic properties of degludec and glargine U300 in relation to the challenges these may pose during the hospitalization of patients with type 2 diabetes who are receiving outpatient regimens involving these newer insulins. Their increased use in clinical practice requires that hospital healthcare professionals (HCPs) have appropriate protocols to transfer patients from these second-generation insulins to formulary insulin on admission, and ensure the safe discharge of patients and transition back to degludec or glargine U300. However, there is no guidance available on this. Based on the authors' clinical experience, we identify key issues to consider when arranging hospital care of such patients. We also summarize the limited available evidence on the potential utility of these second-generation basal insulin analogs in the non-critical inpatient setting and identify avenues for future research. To address current knowledge gaps, it is important that HCPs are educated about the differences between standard formulary insulins and second-generation insulins, and the importance of clear communication during patient transitions. |
| Databáze: | OpenAIRE |
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