PMID- 36830792
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230228
IS  - 2227-9059 (Print)
IS  - 2227-9059 (Electronic)
IS  - 2227-9059 (Linking)
VI  - 11
IP  - 2
DP  - 2023 Jan 18
TI  - Clinical and Pharmacotherapeutic Profile of Patients with Type 2 Diabetes 
      Mellitus Admitted to a Hospital Emergency Department.
LID - 10.3390/biomedicines11020256 [doi]
LID - 256
AB  - Type 2 diabetes mellitus (T2DM) is closely associated with other pathologies, 
      which may require complex therapeutic approaches. We aim to characterize the 
      clinical and pharmacological profile of T2DM patients admitted to an emergency 
      department. Patients aged >/=65 years and who were already using at least one 
      antidiabetic drug were included in this analysis. Blood glycemia, creatinine, 
      aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hemoglobin 
      were analyzed for each patient, as well as personal pathological history, 
      diagnosis(s) at admission, and antidiabetic drugs used before. Outcome variables 
      were analyzed using Pearson's Chi-Square, Fisher's exact test, and linear 
      regression test. In total, 420 patients were randomly selected (48.6% male and 
      51.4% female). Patients with family support showed a lower incidence of high 
      glycemia at admission (p = 0.016). Higher blood creatinine levels were associated 
      with higher blood glycemia (p = 0.005), and hyperuricemia (HU) (p = 0.001), as 
      well as HU, was associated with a higher incidence of acute cardiovascular 
      diseases (ACD) (p = 0.007). Hemoglobin levels are lower with age (p = 0.0001), 
      creatinine (p = 0.009), and female gender (p = 0.03). The lower the AST/ALT 
      ratio, the higher the glycemia at admission (p < 0.0001). Obese patients with (p 
      = 0.021) or without (p = 0.027) concomitant dyslipidemia had a higher incidence 
      of ACD. Insulin (p = 0.003) and glucagon-like peptide-1 agonists (GLP1 RA) (p = 
      0.023) were associated with a higher incidence of decompensated heart failure, 
      while sulfonylureas (p = 0.009), metformin-associated with dipeptidyl peptidase-4 
      inhibitors (DPP4i) (p = 0.029) or to a sulfonylurea (p = 0.003) with a lower 
      incidence. Metformin, in monotherapy or associated with DPP4i, was associated 
      with a lower incidence of acute kidney injury (p = 0.017) or acute chronic kidney 
      injury (p = 0.014). SGLT2i monotherapy (p = 0.0003), associated with metformin (p 
      = 0.026) or with DPP4i (p = 0.007), as well as insulin and sulfonylurea 
      association (p = 0.026), were associated with hydroelectrolytic disorders, unlike 
      GLP1 RA (p = 0.017), DPP4i associated with insulin (p = 0.034) or with a GLP1 RA 
      (p = 0.003). Insulin was mainly used by autonomous and institutionalized patients 
      (p = 0.0008), while metformin (p = 0.003) and GLP1 RA (p < 0.0001) were used by 
      autonomous patients. Sulfonylureas were mostly used by male patients (p = 0.027), 
      while SGLT2 (p = 0.0004) and GLP1 RA (p < 0.0001) were mostly used by patients 
      within the age group 65-85 years. Sulfonylureas (p = 0.008), insulin associated 
      with metformin (p = 0.040) or with a sulfonylurea (p = 0.048), as well as DPP4i 
      and sulfonylurea association (p = 0.031), were associated with higher blood 
      glycemia. T2DM patients are characterized by great heterogeneity from a clinical 
      point of view presenting with several associated comorbidities, so the 
      pharmacotherapeutic approach must consider all aspects that may affect disease 
      progression.
FAU - Lopes, Antonio Cabral
AU  - Lopes AC
AD  - Pharmaceutical Services of Unity Local of Health of Guarda (ULS da Guarda), 
      6300-035 Guarda, Portugal.
AD  - Health Sciences Faculty, University of Beira Interior (FCS-UBI), 6200-506 
      Covilha, Portugal.
FAU - Lourenco, Olga
AU  - Lourenco O
AUID- ORCID: 0000-0002-8401-5976
AD  - Health Sciences Faculty, University of Beira Interior (FCS-UBI), 6200-506 
      Covilha, Portugal.
AD  - Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 
      6200-506 Covilha, Portugal.
FAU - Roque, Fatima
AU  - Roque F
AUID- ORCID: 0000-0003-0169-3788
AD  - Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 
      6200-506 Covilha, Portugal.
AD  - Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), 
      6300-559 Guarda, Portugal.
FAU - Morgado, Manuel
AU  - Morgado M
AUID- ORCID: 0000-0003-2112-2835
AD  - Health Sciences Faculty, University of Beira Interior (FCS-UBI), 6200-506 
      Covilha, Portugal.
AD  - Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 
      6200-506 Covilha, Portugal.
AD  - Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), 
      6300-559 Guarda, Portugal.
AD  - Pharmaceutical Services of University Hospital Center of Cova da Beira, 6200-251 
      Covilha, Portugal.
LA  - eng
PT  - Journal Article
DEP - 20230118
PL  - Switzerland
TA  - Biomedicines
JT  - Biomedicines
JID - 101691304
PMC - PMC9953569
OTO - NOTNLM
OT  - Type 2 diabetes mellitus
OT  - cardiovascular disorders
OT  - glycemia
OT  - kidney function
COIS- The authors declare no conflict of interest.
EDAT- 2023/02/26 06:00
MHDA- 2023/02/26 06:01
PMCR- 2023/01/18
CRDT- 2023/02/25 01:25
PHST- 2022/12/14 00:00 [received]
PHST- 2023/01/12 00:00 [revised]
PHST- 2023/01/17 00:00 [accepted]
PHST- 2023/02/25 01:25 [entrez]
PHST- 2023/02/26 06:00 [pubmed]
PHST- 2023/02/26 06:01 [medline]
PHST- 2023/01/18 00:00 [pmc-release]
AID - biomedicines11020256 [pii]
AID - biomedicines-11-00256 [pii]
AID - 10.3390/biomedicines11020256 [doi]
PST - epublish
SO  - Biomedicines. 2023 Jan 18;11(2):256. doi: 10.3390/biomedicines11020256.