Keywords
Type 2 Diabetes Mellitus
Hyperglycemia
Hospitalization/Inpatient
Antidiabetic drugs
Oral hypoglycemics
How to Cite
Abstract
Background: Hyperglycemia in hospitalized patients is related to the development of complications and in-hospital mortality, currently its treatment is focused on the use of insulins. The intrahospital insulin formulation practices in our setting are unknown.
Purpose: To describe the insulinization schemes used in hospitalized type 2 diabetic patients (DM2), without a history of insulin use, as well as their indication and prescription at discharge.
Methodology: Retrospective cross-sectional study, which included adult patients hospitalized in two university hospitals during 2018 who were prescribed insulin for the management of DM2.
Results: 383 patients were included, 67 years of average age and 53% women. The indications for the initiation of insulin were being hospitalized (73.9%), diabetes decompensations and elevated HbA1c. The schemes used from highest to lowest frequency were basal 55.6%, basal / bolus 43.6%, and basal / plus 0.8%. The most used long-acting insulin was glargine in 95.8% of the cases and the short-acting glulisine in 69.4% of the cases. 244 (77.2%) patients were discharged with insulin therapy, of which 46.7% had a glycated hemoglobin (HbA1c) <10% and 83.2% were discharged without oral hypoglycemic drug, of which 96% had no contraindications for its use and 34% had Hb1Ac ?10%.
Conclusions: In hospitalized type 2 diabetics, the main indication for the initiation of insulin was the hospitalization itself. Basal and basal / bolus schemes predominated in a similar proportion and preference was shown for the use of insulin analogues, especially glargine and glulisine. The insulin prescription at discharge was high, with low use of oral antidiabetic drugs despite having no contraindication.
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