PMID- 34028699
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210721
IS  - 1869-6953 (Print)
IS  - 1869-6961 (Electronic)
IS  - 1869-6961 (Linking)
VI  - 12
IP  - 7
DP  - 2021 Jul
TI  - Insulin Management of Patients with Inadequately Controlled Type 2 Diabetes 
      Admitted to Hospital: Titration Patterns and Frequency of Hypoglycemia as Results 
      of a Prospective Observational Study (Hospital Study).
PG  - 1799-1808
LID - 10.1007/s13300-021-01080-4 [doi]
AB  - INTRODUCTION: Despite the continuously growing number of therapeutic options for 
      type 2 diabetes mellitus (T2DM) including insulins, a large percentage of 
      patients fail to achieve HbA1c targets. Several real-world studies focused on 
      patients with T2DM receiving insulin treatment in outpatient settings were 
      conducted, but information about real-world in-hospital insulin management is 
      lacking. The aim of this study was to describe the management of insulin therapy 
      with a focus on basal-bolus and premixed insulin regimens in patients with T2DM 
      under routine in-hospital medical practice in the Czech Republic. METHODS: This 
      non-interventional prospective study was conducted from June 2014 to December 
      2017 in 22 centers in the Czech Republic under routine clinical practice 
      conditions. Adult patients admitted to hospital with metabolically uncontrolled 
      T2DM [HbA1c >/= 60 mmol/mol; > 7.6% Diabetes Control and Complications Trial 
      (DCCT)] and there treated with basal-bolus and premixed insulin regimens were 
      documented during hospitalization. RESULTS: Overall, 369 patients with T2DM 
      (54.7% male, mean age 64.44 +/- 13.84 years, BMI 31.10 +/- 6.00 kg/m(2), duration of 
      diabetes 8.11 +/- 9.93 years, HbA1c 95.90 +/- 24.38 mmol/mol, length of stay was 
      7.94 +/- 4.53 days) were included. The percentage of glucose values under 10 mmol/l 
      at time of randomization (the group with basal-bolus insulin regimen vs. the 
      premix insulin regimen group) was 24.2% vs. 33.5% (p = 0.053), at time of first 
      insulin dose adjustment it was 43.1% vs. 50.0% (p = 0.330), and 1 day before 
      hospital discharge it was 61.7% vs. 61.4% (p = 0.107). A hypoglycemic event 
      occurred in a total of 15 patients in the basal-bolus regimen group, and no 
      hypoglycemic event occurred in the premixed insulin regimen group. CONCLUSION: 
      In-hospital insulin management regarding basal-bolus and premixed insulin 
      regimens is safe and in concordance with current international recommendations.
FAU - Broz, Jan
AU  - Broz J
AUID- ORCID: 0000-0003-2465-7333
AD  - Department of Internal Medicine, Second Faculty of Medicine, Charles University, 
      V Uvalu 84, 150 00, Prague, Czech Republic. zorb@seznam.cz.
FAU - Janickova Zdarska, Denisa
AU  - Janickova Zdarska D
AD  - Department of Internal Medicine, Second Faculty of Medicine, Charles University, 
      V Uvalu 84, 150 00, Prague, Czech Republic.
FAU - Urbanova, Jana
AU  - Urbanova J
AD  - Department of Internal Medicine, Third Faculty of Medicine and Faculty Hospital 
      Kralovske Vinohrady, Charles University, Prague, Czech Republic.
FAU - Pithova, Pavlina
AU  - Pithova P
AD  - Department of Internal Medicine, Second Faculty of Medicine, Charles University, 
      V Uvalu 84, 150 00, Prague, Czech Republic.
FAU - Donicova, Viera
AU  - Donicova V
AD  - Private Department of Diabetology, Internal Medicine and Metabolism, Kosice, 
      Slovakia.
FAU - Palova, Sabina
AU  - Palova S
AD  - Department of Internal Medicine, Second Faculty of Medicine, Charles University, 
      V Uvalu 84, 150 00, Prague, Czech Republic.
FAU - Pelechova, Barbora
AU  - Pelechova B
AD  - Department of Internal Medicine, Second Faculty of Medicine, Charles University, 
      V Uvalu 84, 150 00, Prague, Czech Republic.
FAU - Smrzova, Anna
AU  - Smrzova A
AD  - Institute of Biostatistics and Analyses, Ltd., Brno, Czech Republic.
FAU - Kvapil, Milan
AU  - Kvapil M
AD  - Department of Internal Medicine, Second Faculty of Medicine, Charles University, 
      V Uvalu 84, 150 00, Prague, Czech Republic.
LA  - eng
PT  - Journal Article
DEP - 20210524
PL  - United States
TA  - Diabetes Ther
JT  - Diabetes therapy : research, treatment and education of diabetes and related 
      disorders
JID - 101539025
PMC - PMC8266977
OTO - NOTNLM
OT  - Basal-bolus regimen
OT  - HbA1c
OT  - Hospital insulin management
OT  - Hypoglycemia
OT  - Insulin titration
OT  - Premixed insulin regimen
OT  - Type 2 diabetes
EDAT- 2021/05/25 06:00
MHDA- 2021/05/25 06:01
PMCR- 2021/05/24
CRDT- 2021/05/24 12:37
PHST- 2020/11/17 00:00 [received]
PHST- 2021/05/12 00:00 [accepted]
PHST- 2021/05/25 06:00 [pubmed]
PHST- 2021/05/25 06:01 [medline]
PHST- 2021/05/24 12:37 [entrez]
PHST- 2021/05/24 00:00 [pmc-release]
AID - 10.1007/s13300-021-01080-4 [pii]
AID - 1080 [pii]
AID - 10.1007/s13300-021-01080-4 [doi]
PST - ppublish
SO  - Diabetes Ther. 2021 Jul;12(7):1799-1808. doi: 10.1007/s13300-021-01080-4. Epub 
      2021 May 24.