Breaking Therapeutic Inertia in Type 2 Diabetes : Active Detection of In-Patient Cases Allows Improvement of Metabolic Control at Midterm
Lucas Martín, Anna (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Guanyabens, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Zavala-Arauco, R. (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Chamorro, Joaquín (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Granada, Maria Luisa (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Puig Domingo, Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Mauricio Puente, Dídac (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2015
Abstract:	Type 2 diabetes (T2D) exists in 25-40% of hospitalized patients. Therapeutic inertia is the delay in the intensification of a treatment and it is frequent in T2D. The objectives of this study were to detect patients admitted to surgical wards with hyperglycaemia (HH; fasting glycaemia > 140 mg/dL) as well as those with T2D and suboptimal chronic glycaemic control (SCGC) and to assess the midterm impact of treatment modifications indicated at discharge. A total of 412 HH patients were detected in a period of 18 months; 86. 6% (357) had a diagnosed T2D. Their preadmittance HbA was 7. 7 ± 1. 5%; 47% (189) had HbA ≥ 7. 4% (SCGC) and were moved to the upper step in the therapeutic algorithm at discharge. Another 15 subjects (3. 6% of the cohort) had T2D according to their current HbA. Ninety-four of the 189 SCGC patients were evaluated 3-6 months later. Their HbA before in-hospital-intervention was 8. 6 ± 1. 2% and 7. 5 ± 1. 2% at follow-up (P < 0. 004). Active detection of hyperglycaemia in patients admitted in conventional surgical beds permits the identification of T2D patients with SCGC as well as previously unknown cases. A shift to the upper step in the therapeutic algorithm at discharge improves this control. Hospitalization is an opportunity to break therapeutic inertia.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	International Journal of Endocrinology, Vol. 2015 (may 2015) , ISSN 1687-8345

DOI: 10.1155/2015/381415
PMID: 26089883

5 p, 495.6 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
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