© 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.
Lucas Martín, A. M., Guanyabens, E., Zavala-Arauco, R., Chamorro, J., Granada, M. L., Mauricio, D., & Puig-Domingo, M. (2015). Breaking therapeutic inertia in type 2 diabetes: Active detection of in-patient cases allows improvement of metabolic control at midterm. International Journal of Endocrinology, 2015, . https://doi.org/10.1155/2015/381415