Petite Sarah E, Hill Maja C
University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, OH, USA.
J Pharm Pract. 2022 Apr;35(2):229-234. doi: 10.1177/0897190020966150. Epub 2020 Oct 23.
The American Diabetes Association recommends discontinuing non-insulin antihyperglycemic therapy during hospitalization and utilizing a basal insulin-containing regimen for patients with type 2 diabetes mellitus (T2DM). Limited research is available on the role of dipeptidyl peptidase-IV (DPP-IV) inhibitors in an inpatient real-world patient population.
To determine the efficacy of DPP-IV inhibitor therapy in hospitalized patients with T2DM.
Adult patients with T2DM and received at least one dose of DPP-IV inhibitor during hospitalization were included. The primary outcome was to determine the mean daily blood glucose (BG) readings in the overall patient population. Secondary outcomes included comparing study groups and evaluating mean daily blood glucose, hospital length of stay (LOS) and incidence of hypoglycemia.
One hundred and ninety-two patients were identified: 39 patients (20.3%) received DPP-IV inhibitor monotherapy, 104 (54.2%) received DPP-IV inhibitor plus oral antihyperglycemics and 49 (25.5%) received DPP-IV inhibitor plus insulin. Mean daily BG in the entire study population was 158.7 mg/dL (131-187.5). Mean daily BG was significantly different between groups (117 mg/dL [103.5-132.3] vs. 160.7 mg/dL [133-181.1] vs. 179.4 mg/dL [153.8-216.6]; (P < 0.001). Hypoglycemic events were higher in the DPP-IV inhibitor plus insulin group (2.6% vs. 3.8% vs. 16.3%; P = 0.008). There were no significant differences in hospital LOS (2 days [1-4] vs. 3 days [1-5] vs. 4 days [2-6.5]; P = 0.051).
Inpatient DPP-IV inhibitor use was associated with mean daily BG within goal range. Administering DPP-IV inhibitors in the inpatient setting should be considered in hospitalized patients with controlled T2DM.
美国糖尿病协会建议2型糖尿病（T2DM）患者在住院期间停用非胰岛素类降糖治疗，并采用含基础胰岛素的治疗方案。关于二肽基肽酶-IV（DPP-IV）抑制剂在住院的真实患者群体中的作用，现有研究有限。
确定DPP-IV抑制剂治疗住院T2DM患者的疗效。
纳入成年T2DM患者，这些患者在住院期间至少接受过一剂DPP-IV抑制剂治疗。主要结局是确定总体患者群体的平均每日血糖（BG）读数。次要结局包括比较研究组，并评估平均每日血糖、住院时间（LOS）和低血糖发生率。
共确定了192例患者：39例（20.3%）接受DPP-IV抑制剂单药治疗，104例（54.2%）接受DPP-IV抑制剂加口服降糖药治疗，49例（25.5%）接受DPP-IV抑制剂加胰岛素治疗。整个研究群体的平均每日BG为158.7mg/dL（131 - 187.5）。各组间平均每日BG有显著差异（117mg/dL [103.5 - 132.3] 对比 160.7mg/dL [133 - 181.1] 对比 179.4mg/dL [153.8 - 216.6]；P < 0.001）。DPP-IV抑制剂加胰岛素组的低血糖事件发生率更高（2.6%对比3.8%对比16.3%；P = 0.008）。住院时间无显著差异（2天 [1 - 4] 对比3天 [1 - 5] 对比4天 [2 - 6.5]；P = 0.051）。
住院期间使用DPP-IV抑制剂与平均每日BG处于目标范围内相关。对于T2DM得到控制的住院患者，应考虑在住院期间给予DPP-IV抑制剂治疗。
