Evidence-based therapeutics for hyperglycemia in hospitalized noncritically ill patients

Gracia‐Ramos, Abraham Edgar; Carretero-Gómez, Juana; Mendez, Carlos E.; Carrasco-Sánchez, Francisco Javier

doi:10.1080/03007995.2021.1997288

Cited by 3 publications

(1 citation statement)

References 74 publications

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“…Hyperglycemia in hospitalized patients has been associated with unfavorable outcomes, including increased mortality, higher infection rates, and prolonged hospital stays. 21 – 23 Hyperglycemia also promotes viral replication, increases viral load, and extends viral shedding. 24 , 25 Individuals with diabetes tend to have a greater release of proinflammatory cytokine, compromised host immune responses, and endothelial dysfunction, potentially leading to a more severe clinical response to COVID-19.…”

Section: Introductionmentioning

confidence: 99%

Optimal initial insulin dosage for managing steroid-induced hyperglycemia in hospitalized COVID-19 patients: A retrospective single-center study

Ketaroonrut,

Kiertiburanakul,

Sriphrapradang

2024

SAGE Open Medicine

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Objectives: To determine the optimal initial insulin dosage for controlling hyperglycemia in COVID-19 patients receiving steroids, an area with limited data. Methods: We retrospectively analyzed 156 COVID-19 patients with steroid-induced hyperglycemia treated with insulin. Patients were categorized by their total daily dose of subcutaneous insulin therapy when starting dexamethasone ⩾6 mg/day or equivalent dose of glucocorticoid: Group A (⩽0.29 units/kg), Group B (0.3–0.49 units/kg), Group C (0.5–0.69 units/kg), and Group B (⩾0.7 units/kg). Treatment failure was defined as mean blood glucose level > 280 mg/dL for two consecutive days after initiating insulin or any blood glucose ⩾ 400 mg/dL. Results: The mean age was 64 ± 14 years, with 50% male, and a mean body mass index of 26.9 ± 6.9 kg/m2. Most had preexisting type 2 diabetes (62%). Mean admission blood glucose and HbA1c were 233 ± 112 mg/dL and 7.8 ± 2.3%, respectively. Group A had the lowest HbA1c (6.7 ± 1.2%), while group D had the highest (9.8 ± 2.5%). Median daily dexamethasone dosage or equivalent was 36 (IQR 16.72) mg, with no significant differences in among groups. Group A had the lowest treatment failure rate. There were no significant differences in treatment failure rate between Groups B, C, and D. Additionally, there were no statistically significant differences in mean BG across the groups: Group A 232 ± 42 mg/dL, Group B 247 ± 57 mg/dL, Group C 247 ± 61 mg/dL, and Group D 227 ± 67 mg/dL ( p = 0.2). Group D had a significantly higher rate of level 1 hypoglycemia ( p = 0.008), while no differences in clinically significant hypoglycemia (level 2 or 3) were observed between groups. Conclusions: Among patients requiring TDD ⩾ 0.3 units/kg/day, there was no significant difference in treatment failure rate between Groups B, C, and D. Group D had the highest rate of level 1 hypoglycemia. This initial insulin dosage for hospitalized COVID-19 patients on high-dose steroid therapy should be personalized.

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Section: Introductionmentioning

confidence: 99%

Optimal initial insulin dosage for managing steroid-induced hyperglycemia in hospitalized COVID-19 patients: A retrospective single-center study

Ketaroonrut,

Kiertiburanakul,

Sriphrapradang

2024

SAGE Open Medicine

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Efficacy and safety of sitagliptin with basal-plus insulin regimen versus insulin alone in non-critically ill hospitalized patients with type 2 diabetes: SITA-PLUS hospital trial

Gracia-Ramos,

Cruz-Dominguez,

Madrigal-Santillán

et al. 2024

Journal of Diabetes and its Complications

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Terapéutica no insulínica para los pacientes hospitalizados con diabetes tipo 2

Gracia-Ramos

2023

Salud Jalisco

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La hiperglucemia es una condición común, costosa y nociva para los pacientes hospitalizados con diabetes tipo 2, y aunque la terapéutica estándar está basada en la administración de insulina (principalmente mediante un esquema basal-bolo), su implementación en la práctica clínica presenta varias dificultades, tales como la complejidad en los esquemas de aplicación o el riesgo de hipoglucemia. Por lo anterior, en los últimos años se han realizado varios estudios para explorar el uso de terapéutica no insulínica en este grupo de pacientes, en particular con la terapia basada en incretinas (inhibidores de la dipeptidil-peptidasa-4, agonistas de los receptores del péptido similar a glucagón 1). Esta revisión aborda la evidencia actual con respecto de la terapéutica no insulínica para los pacientes con diabetes tipo 2 hospitalizados fuera de una Unidad de Cuidados Intensivos.

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Evidence-based therapeutics for hyperglycemia in hospitalized noncritically ill patients

Cited by 3 publications

References 74 publications

Optimal initial insulin dosage for managing steroid-induced hyperglycemia in hospitalized COVID-19 patients: A retrospective single-center study

Optimal initial insulin dosage for managing steroid-induced hyperglycemia in hospitalized COVID-19 patients: A retrospective single-center study

Efficacy and safety of sitagliptin with basal-plus insulin regimen versus insulin alone in non-critically ill hospitalized patients with type 2 diabetes: SITA-PLUS hospital trial

Terapéutica no insulínica para los pacientes hospitalizados con diabetes tipo 2

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