Use of Linagliptin for the Management of Medicine Department Inpatients with Type 2 Diabetes in Real-World Clinical Practice (Lina-Real-World Study)

Pérez‐Belmonte, Luis M.; Gómez‐Doblas, Juan José; Millán-Gómez, Mercedes; López-Carmona, María D.; Guijarro-Merino, Ricardo; Carrasco-Chinchilla, Fernando; Teresa–Galván, Eduardo de; Jiménez‐Navarro, Manuel; Bernal-López, María Rosa; Gómez‐Huelgas, Ricardo

doi:10.3390/jcm7090271

Cited by 26 publications

(38 citation statements)

References 32 publications

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“…Finally, the dose of most DPP‐4 inhibitors needs adjustment in kidney disease (GFR <45 ml/min/1.73m 2 ), with the exception of linagliptin, which can be administered irrespectively of renal function, thus being a practical and safe option in the inpatient setting []. On the other hand, linagliptin is liver extracted, therefore, it should be avoided if there are concerns about liver function [42].…”

Section: Discussionmentioning

confidence: 99%

“…Linagliptin was evaluated in a multicentre, randomized controlled trial (RCT), which enrolled non‐critically ill individuals with type 2 diabetes and mild to moderate hyperglycaemia, without a history of injectable hypoglycaemic therapy [42]. A total of 454 participants were randomized to receive either a basal‐bolus regimen or linagliptin and basal insulin.…”

Section: Methodsmentioning

confidence: 99%

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Oral antidiabetes agents for the management of inpatient hyperglycaemia: so far, yet so close

et al. 2020

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Background Hyperglycaemia is an ongoing challenge in hospital settings and is associated with poor outcomes. Current recommendations for the management of inpatient hyperglycaemia suggest insulin as the main glucose-lowering treatment choice and limit the administration of oral antidiabetes agents to a small proportion of cases because of safety concerns. Aim To present and critically appraise the available evidence on the use of oral antidiabetes agents in the hospital setting and the risk-benefit balance of such an approach in the era of cardiovascular outcomes trials. Methods PubMed, Embase and Google Scholar databases were searched to identify relevant published work. Available evidence on the efficacy and the safety profile of oral agents in the context of their use in hospitalized individuals are summarized and discussed in this narrative review. Results There is no robust evidence to suggest the use of metformin, thiazolidinediones, sulfonylureas and sodium-glucose co-transporter-2 inhibitors in the hospital setting, although some of their effects on acute outcomes deserve further evaluation in future studies. However, the use of dipeptidyl peptidase-4 inhibitors in inpatients with type 2 diabetes is supported by a few, well-designed, randomized controlled trials. These trials have demonstrated good safety and tolerability profiles, comparable to insulin glucose-lowering efficacy, and a reduction in insulin dose when dipeptidyl peptidase-4 inhibitors are co-administered with insulin, in individuals with mild to moderate hyperglycaemia and a stable clinical condition. Conclusion The administration of dipeptidyl peptidase-4 inhibitors to specific groups of inpatients might be a safe and effective alternative to insulin.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Oral antidiabetes agents for the management of inpatient hyperglycaemia: so far, yet so close

et al. 2020

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“…In a larger multicenter trial, sitagliptin plus basal insulin fared as well as basal-bolus insulin (41). A smaller study on saxagliptin, trials on linagliptin, and real-J o u r n a l P r e -p r o o f world findings add to information on relative efficacy and safety of DPP-4 inhibitors (42)(43)(44)(45). These studies suggest that DP-4 inhibitors can be used in mild to moderate hyperglycemia, in patients who were not on injectable agents at home, or were on relatively low doses of insulin at home (0.4 unit/kg/day if attempting to use DPP-4 inhibitors without basal insulin, or up to 0.6 unit/kg/day if to be given with basal insulin).…”

Section: Non-critical Illnessmentioning

confidence: 98%

Inpatient Hyperglycemia and Transitions of Care: A Systematic Review

2021

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“…11 There are pilot trials on dipeptidyl peptidase-IV (DPP-IV) inhibitors with and without basal insulin that so far have shown similar glucose control as basal-bolus insulin therapy. 12-15 The glucagon-like peptide-1 (GLP-1) receptor agonists have also shown promise. 16 The sodium-glucose cotransporter-2 (SGLT-2) inhibitors are currently not recommended due to lack of available literature and their unfavorable adverse effect profile.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Safety and Efficacy of Metformin Use in Hospitalized, Non–Critically Ill Patients

Alauddin

Petite

2020

Journal of Pharmacy Technology

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Background: Contraindications and precautions to metformin have limited inpatient use, and limited evidence exists evaluating metformin in hospitalized patients. Objective: This study aimed to determine the safety and efficacy of inpatient metformin use. Methods: This study was an observational, retrospective, cohort study at an academic medical center between June 1, 2016, and May 31, 2018. Hospitalized adults with type 2 diabetes mellitus receiving at least 1 metformin dose were included. The primary endpoint was to identify hospitalized patients using metformin with at least 1 contraindication or precautionary warning against use. Secondary endpoints included assessing metformin efficacy with glycemic control, characterizing adverse outcomes of inpatient metformin, and comparing the efficacy of metformin-containing regimens. Results: Two hundred patients were included. There were 126 incidences of potentially unsafe use identified in 111 patients (55.5%). The most common reasons were age ≥65 years (47%), heart failure diagnosis (7.5%), and metformin within 48 hours of contrast (6%). Metformin was contraindicated in 2 patients (1%) with an estimated glomerular filtration rate ≤30 mL/min/1.73 m2. The overall median daily blood glucose was 146 mg/dL (interquartile range [IQR] = 122-181). Patients were divided into 3 groups: metformin monotherapy, metformin plus oral antihyperglycemic therapy, and metformin plus insulin. The median daily blood glucoses were 129 mg/dL (IQR = 110-152), 154 mg/dL (IQR = 133-178), and 174 mg/dL (IQR = 142-203; P < .001), respectively. Two patients (1%) developed acute kidney injury, and no patients developed lactic acidosis. Conclusions: Metformin was associated with goal glycemic levels in hospitalized patients with no adverse outcomes. These results suggest the potential for metformin use in hospitalized, non–critically ill patients.

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Use of Linagliptin for the Management of Medicine Department Inpatients with Type 2 Diabetes in Real-World Clinical Practice (Lina-Real-World Study)

Cited by 26 publications

References 32 publications

Oral antidiabetes agents for the management of inpatient hyperglycaemia: so far, yet so close

Oral antidiabetes agents for the management of inpatient hyperglycaemia: so far, yet so close

Inpatient Hyperglycemia and Transitions of Care: A Systematic Review

Evaluation of the Safety and Efficacy of Metformin Use in Hospitalized, Non–Critically Ill Patients

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