Safety and Efficacy of Inpatient Diabetes Management with Non-insulin Agents: an Overview of International Practices

• Authors: Rodolfo Galindo, Emory University; Ketan Dhatariya, NHS Foundation Trust; Fernando Gomez-Peralta, Segovia General Hospital; Guillermo Umpierrez, Emory University
• Journal Title: CURRENT DIABETES REPORTS
• Volume: Volume 22, Number 6
• Publisher: CURRENT MEDICINE GROUP | 2022-05-04, Pages 237-246
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1007/s11892-022-01464-1
• Subjects: Health Sciences, Medicine and Surgery; Health Sciences, Nutrition
• Keywords: Science & Technology; Life Sciences & Biomedicine; Endocrinology & Metabolism; Inpatient hyperglycemia; Hospital diabetes; SLIDING SCALE INSULIN; CLINICAL-PRACTICE GUIDELINE; GLYCEMIC CONTROL; HOSPITALIZED-PATIENTS; CARDIAC-SURGERY; PERIOPERATIVE MANAGEMENT; INTRAVENOUS EXENATIDE; AMERICAN ASSOCIATION; SEVERE HYPOGLYCEMIA; ADMISSION GLUCOSE

Abstract

Purpose of Review: The field of inpatient diabetes has advanced significantly over the last 20 years, leading to the development of personalized treatment approaches. However, outdated guidelines still recommend the use of basal-bolus insulin therapy as the preferred treatment approach, and against the use of non-insulin anti-hyperglycemic agents. Recent Findings: Several observational and prospective randomized controlled studies have demonstrated that oral anti-hyperglycemic agents are widely used in the hospital, including studies of DPP-4 agents and GLP-1 agonists. Summary: With advances in the field of inpatient diabetes management, a paradigm shift has occurred, from an approach of recommending “basal-bolus regimens” for all patients to a more precision medicine option for hospitalized non-critically ill patients with type 2 diabetes.