Compliance with Prescription Guidelines for Glucose-Lowering Therapies According to Renal Function: Real-Life Study in Inpatients of Internal Medicine, Endocrinology and Cardiology Units

Background and objectives: Renal failure is a contraindication for some glucose-lowering drugs and requires dosage adjustment for others, particularly biguanides, sulfonylureas, and inhibitors of dipeptidyl peptidase 4. In this study, we assessed adherence to prescription recommendations for glucose...

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Vydáno v:	Medicina (Kaunas, Lithuania) Ročník 57; číslo 12; s. 1376
Hlavní autoři:	Lohan, Laura, Galtier, Florence, Manson, Thibault, Mura, Thibault, Castet-Nicolas, Audrey, Faure, Delinger, Chapet, Nicolas, Leclercq, Florence, Pasquié, Jean Luc, Roubille, François, Roubille, Camille, Blain, Hubert, Guilpain, Philippe, Villiet, Maxime, Avignon, Antoine, Sultan, Ariane, Breuker, Cyril
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Switzerland MDPI AG 17.12.2021 MDPI
Témata:	Cardiology cardiovascular medicine Contraindications Diabetes diabetes mellitus Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Drug dosages Drug stores Endocrinology Endocrinology and metabolism Geriatrics Glucose glucose-lowering drugs Guideline Adherence Heart failure Hospitalization Hospitals Human health and pathology Humans Hypoglycemia Hypoglycemic Agents - adverse effects Inappropriate Prescribing Inpatients Insulin Internal Medicine Kidney - physiology Kidney - physiopathology Kidney diseases Life Sciences Medical records Medicine Patients Pharmaceutical sciences Pharmacology prescription guidelines Prospective Studies renal function Urology and Nephrology United States > US renal function diabetes mellitus glucose-lowering drugs prescription guidelines cardiovascular medicine Glucose-lowering drugs Prescription guidelines Renal function Cardiovascular medicine Diabetes mellitus
ISSN:	1648-9144, 1010-660X, 1648-9144
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Shrnutí:	Background and objectives: Renal failure is a contraindication for some glucose-lowering drugs and requires dosage adjustment for others, particularly biguanides, sulfonylureas, and inhibitors of dipeptidyl peptidase 4. In this study, we assessed adherence to prescription recommendations for glucose-lowering drugs according to renal function in hospitalized diabetic subjects. Materials and Methods: This prospective cohort study was carried out over a 2-year period in a university hospital. Glomerular filtration rate (GFR) was determined by averaging all measurements performed during hospitalization. Glucose-lowering drug dosages were analyzed according to the recommendations of the relevant medical societies. Results: In total, 2071 diabetic patients (53% hospitalized in cardiology units) were examined. GFR was <30 mL/min/1.73 m2 in 13.4% of these patients, 30–44 in 15.1%, 45–60 in 18.3%, and >60 in 53.3%. Inappropriate oral glucose-lowering treatments were administered to 273 (13.2%) patients, including 53 (2.6%) with a contraindication. In cardiology units, 53.1% and 14.3% of patients had GFRs of <60 and <30 mL/min/1.73 m2, respectively, and 179 (15.4%) patients had a contraindication or were prescribed an excessive dose of glucose-lowering drugs. Conclusions: We showed that the burden of inappropriate prescriptions is high in diabetic patients. Given the high number of patients receiving these medications, particularly in cardiology units, a search for potential adverse effects related to these drugs should be performed.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 PMCID: PMC8704212 These authors contributed equally to this work.
ISSN:	1648-9144 1010-660X 1648-9144
DOI:	10.3390/medicina57121376