Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave., Suite 530, Chicago, IL, 60611, USA.
Curr Diab Rep. 2019 Jul 26;19(9):64. doi: 10.1007/s11892-019-1183-9.
Insulin has been the standard of care for the management of inpatient diabetes for achieving strict glycemic control. This review supports continuing insulin therapy for hyperglycemic management in the hospital compared with the use of non-insulin treatment regimens.
Oral hypoglycemic agents and glucagon-like peptide 1 (GLP-1) receptor agonists have typically not been used in the inpatient setting. Recent studies regarding DPP-4 inhibitors have led to variable results with fairly high glycemic values during the hospitalization. Similarly, studies looking at GLP-1 receptor agonists are limited, but gastrointestinal side effects limit their inpatient use. Overall, there is a paucity of data to support the use of non-insulin-based therapy in the inpatient setting. Insulin has repeatedly demonstrated that its advantageous quality of being easily titratable leads to more consistently efficacious glycemic control that improves morbidity and mortality.
胰岛素一直是住院糖尿病患者强化血糖控制的标准治疗方法。与非胰岛素治疗方案相比，本综述支持继续使用胰岛素治疗来控制高血糖。
口服降糖药和胰高血糖素样肽 1（GLP-1）受体激动剂通常不在住院环境中使用。最近关于二肽基肽酶 4（DPP-4）抑制剂的研究结果差异较大，住院期间血糖值相当高。同样，关于 GLP-1 受体激动剂的研究也很有限，但胃肠道副作用限制了它们在住院患者中的使用。总的来说，缺乏数据支持在住院环境中使用非胰岛素为基础的治疗。胰岛素已反复证明，其易于滴定的优势质量可更有效地控制血糖，从而降低发病率和死亡率。
