TY - JOUR
T1 - Breaking therapeutic inertia in type 2 diabetes: Active detection of in-patient cases allows improvement of metabolic control at midterm
AU - Lucas Martín, Anna M.
AU - Guanyabens, Elena
AU - Zavala-Arauco, R.
AU - Chamorro, Joaquín
AU - Granada, Maria Luisa
AU - Mauricio, Didac
AU - Puig-Domingo, Manuel
PY - 2015/1/1
Y1 - 2015/1/1
N2 - © 2015 Anna M. Lucas Martín et al. Type 2 diabetes (T2D) exists in 25-40% of hospitalized patients. Therapeutic inertia is the delay in the intensification of a treatment and it is frequent in T2D. The objectives of this study were to detect patients admitted to surgical wards with hyperglycaemia (HH; fasting glycaemia > 140 mg/dL) as well as those with T2D and suboptimal chronic glycaemic control (SCGC) and to assess the midterm impact of treatment modifications indicated at discharge. A total of 412 HH patients were detected in a period of 18 months; 86.6% (357) had a diagnosed T2D. Their preadmittance HbA 1c was 7.7 ± 1.5%; 47% (189) had HbA 1c ≥ 7.4% (SCGC) and were moved to the upper step in the therapeutic algorithm at discharge. Another 15 subjects (3.6% of the cohort) had T2D according to their current HbA 1c. Ninety-four of the 189 SCGC patients were evaluated 3-6 months later. Their HbA 1c before in-hospital-intervention was 8.6 ± 1.2% and 7.5 ± 1.2% at follow-up (P < 0.004). Active detection of hyperglycaemia in patients admitted in conventional surgical beds permits the identification of T2D patients with SCGC as well as previously unknown cases. A shift to the upper step in the therapeutic algorithm at discharge improves this control. Hospitalization is an opportunity to break therapeutic inertia.
AB - © 2015 Anna M. Lucas Martín et al. Type 2 diabetes (T2D) exists in 25-40% of hospitalized patients. Therapeutic inertia is the delay in the intensification of a treatment and it is frequent in T2D. The objectives of this study were to detect patients admitted to surgical wards with hyperglycaemia (HH; fasting glycaemia > 140 mg/dL) as well as those with T2D and suboptimal chronic glycaemic control (SCGC) and to assess the midterm impact of treatment modifications indicated at discharge. A total of 412 HH patients were detected in a period of 18 months; 86.6% (357) had a diagnosed T2D. Their preadmittance HbA 1c was 7.7 ± 1.5%; 47% (189) had HbA 1c ≥ 7.4% (SCGC) and were moved to the upper step in the therapeutic algorithm at discharge. Another 15 subjects (3.6% of the cohort) had T2D according to their current HbA 1c. Ninety-four of the 189 SCGC patients were evaluated 3-6 months later. Their HbA 1c before in-hospital-intervention was 8.6 ± 1.2% and 7.5 ± 1.2% at follow-up (P < 0.004). Active detection of hyperglycaemia in patients admitted in conventional surgical beds permits the identification of T2D patients with SCGC as well as previously unknown cases. A shift to the upper step in the therapeutic algorithm at discharge improves this control. Hospitalization is an opportunity to break therapeutic inertia.
U2 - https://doi.org/10.1155/2015/381415
DO - https://doi.org/10.1155/2015/381415
M3 - Article
SN - 1687-8337
VL - 2015
JO - International Journal of Endocrinology
JF - International Journal of Endocrinology
M1 - 381415
ER -
