Article ; Online: Impact of Insulin Degludec in Hospitalized Patients With and Without Type 2 Diabetes Requiring Parenteral/Enteral Nutrition: An Observational Study.
2018 Volume 35, Issue 6, Page(s) 809–816
Abstract: Introduction: Hyperglycemia in inpatients is a major problem, especially when nutritional support is required. This study aims to assess the impact of treatment with insulin degludec (IDeg) on mean blood glucose (BG) and glycemic variability in ... ...
| Abstract | Introduction: Hyperglycemia in inpatients is a major problem, especially when nutritional support is required. This study aims to assess the impact of treatment with insulin degludec (IDeg) on mean blood glucose (BG) and glycemic variability in noncritical hospitalized patients with and without type 2 diabetes (T2DM) receiving enteral and/or parenteral nutrition (EN, PN). Methods: Mean BG and glycemic variability from admission up to 7 days of hospitalization were evaluated in consecutive cases with and without T2DM. Percentage of coefficient of variation (CV) for glucose was used to express glycemic variability. Results: Overall, 26 patients (13 with and 13 without T2DM) were admitted to the hospital for any cause. Subjects were 65.4% men and they were mainly elderly (mean age 66.3 ± 13.4 years). PN was administered in 88.5% of patients and EN in 19.2%. At admission, mean HbA1c level was 5.9 ± 0.7% in patients without diabetes and 9.1 ± 2.5% in patients with T2DM. During hospitalization, mean daily BG levels changed from 151 ± 47.3 mg/dl (day 1) to 157 ± 66.7 mg/dl (day 7) in patients without diabetes and from 210 ± 66.5 mg/dl to 192 ± 48.6 mg/dl in patients with T2DM. CV decreased from 14% (day 1) to 11% (day 7) in patients without diabetes and from 20% (day 1) to 9% (day 7) in patients with T2DM. No symptomatic or severe hypoglycemia occurred. Conclusions: Despite the small sample size and the lack of control group, this study represents the first proof-of-concept that IDeg in hospitalized patients with or without T2DM who require nutritional support has the potential to maintain stable levels of BG and reduce glycemic variability. Funding: Novo Nordisk S.p.A. grant. |
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| MeSH term(s) | Aged ; Aged, 80 and over ; Blood Glucose/analysis ; Diabetes Mellitus, Type 2/drug therapy ; Enteral Nutrition ; Female ; Humans ; Hyperglycemia/drug therapy ; Hypoglycemia/drug therapy ; Inpatients ; Insulin, Long-Acting/therapeutic use ; Male ; Middle Aged ; Parenteral Nutrition |
| Chemical Substances | Blood Glucose ; Insulin, Long-Acting |
| Language | English |
| Publishing date | 2018-05-17 |
| Publishing country | United States |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 632651-1 |
| ISSN | 1865-8652 ; 0741-238X |
| ISSN (online) | 1865-8652 |
| ISSN | 0741-238X |
| DOI | 10.1007/s12325-018-0709-x |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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