Simplified glycaemic management for patients with type 2 diabetes admitted for acute decompensated heart failure using linagliptin

Med Clin (Barc). 2022 Feb 25;158(4):173-177. doi: 10.1016/j.medcli.2021.02.009. Epub 2021 Apr 10.
[Article in English, Spanish]

Abstract

Introduction and objectives: Hyperglycaemia in hospitalized patients with type 2 diabetes is preferably managed with insulin. We aimed to analyse the glycaemic efficacy, treatment simplicity, and safety of our hospital's antihyperglycemic regimens (linagliptin-basal insulin versus basal-bolus insulin) in patients with type 2 diabetes admitted for heart failure decompensation.

Patients and methods: In this real-world study, we included patients with mild-to-moderate hyperglycaemia managed with our antihyperglycemic regimens between 2016 and 2018. To match patients who started one of the regimens, a propensity matching analysis was used.

Results: After propensity matching, 146 patients were included in each group. There were no differences in mean blood glucose levels (163.6±21.2 vs 159.6±19.2mg/dl, p=.210). Patients on the linagliptin-basal insulin regimen had a lower total number of hypoglycaemic episodes (36 vs 64, p<.001), lower total insulin dose (24.1±5.3 vs 32.0±5.6 units, p<.001), and lower number of daily injections (2.4±.8 vs 4.0±.0, p<.001) than those on the basal-bolus regimen.

Conclusions: Linagliptin-basal insulin was a safe, simple, and efficacious regimen and could be considered standard of care for these vulnerable, high complex patients to simplify in-hospital management.

Keywords: Diabetes mellitus de tipo 2; Heart failure; Hiperglucemia; Hospitalización; Hospitalization; Hyperglycaemia; Insuficiencia cardíaca; Linagliptin; Linagliptina; Type 2 diabetes.

Publication types

  • Case Reports

MeSH terms

  • Blood Glucose
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glycated Hemoglobin / analysis
  • Heart Failure* / drug therapy
  • Humans
  • Hypoglycemia*
  • Hypoglycemic Agents / therapeutic use
  • Insulin
  • Linagliptin / therapeutic use
  • Treatment Outcome

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • Linagliptin