Session: SUN 839-872-Diabetes & Obesity Management
Poster Board SUN-853
Objectives: To identify the frequency of Met/TZD use in non-critically ill patients with T2DM, to report the presence of contraindications or risks factors for adverse drug events (ADEs), and to assess efficacy on glycemic control.
Design: Retrospective chart review study
Setting: Community teaching hospital
Population: 72 patients with T2DM admitted to the medical/ surgical wards in January 2011 were administered Met/TZD. 60 patients received Met, 10 received TZDs, and 2 both.These agents were used alone or with other oral antihyperglycemic agents and/or insulin. 9 patients with ≤3 fingersticks (FS) / 24 hours for >50% of the hospital stay were excluded in the glycemic data.
Outcomes: Percentage of hospitalized patients with T2DM administered Met/TZD; Percentage with contraindications or risk factors for ADEs; Episode rates of hyperglycemia (FS>180 mg/dl) and hypoglycemia (FS<70 mg/dl), calculated as the number of abnormal FS divided by the total FS number for each patient.
Results: In 1 month, 15% (72/490) of patients with T2DM were administered Met/TZD. Forty one (57%) had at least one contraindication or precaution to either drug. In the Met group, 10 (16%) had an elevated Cr(≥1.4-women; ≥1.5-men), 2 (3%) had a high anion gap, 10 (16%) received IV contrast, 6 (10%) received loop diuretics, 17 (27%) had pulmonary disease and 13 (21%) had cardiac disease. In the TZD group, 1 (8%) had congestive heart failure and 3 (25%) had cardiac disease. While on Met/TZD, 35 out of 63 patients (55%) had hyperglycemic episode rates ≥25%. 3 had hypoglycemia.
Conclusions: Met/TZD remain in use in the hospital setting despite current guidelines. More than 55% of patients administered Met/TZD had contraindications or risk factors for ADEs. The inclusion of Met/TZD in a treatment regimen did not result in optimal glycemic control.
Nothing to Disclose: PI, RF, SMP
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