Breaking therapeutic inertia in type 2 diabetes: Active detection of in-patient cases allows improvement of metabolic control at midterm

Anna M. Lucas Martín, Elena Guanyabens, R. Zavala-Arauco, Joaquín Chamorro, Maria Luisa Granada, Didac Mauricio, Manuel Puig-Domingo

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6 Citations (Scopus)

Abstract

© 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.
Original languageEnglish
Article number381415
JournalInternational Journal of Endocrinology
Volume2015
DOIs
Publication statusPublished - 1 Jan 2015

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