Inpatient safety, effectiveness of SGLT2 inhibitors and GLP-1 RAs in type 2 diabetes: ENDOCARE, a pragmatic prospective cohort study
Authors' conclusion
In real hospital settings, the use of non-insulin therapies, predominantly SGLT2 inhibitors and GLP-1 RAs guided by a start-stop CPG, was associated with a safe and effective glycemic management profile.
Study context
- Population
- Adults with T2D admitted to medical and surgical wards of a tertiary hospital, 9-month study
- Participants
- 979 adults
- Exposure
- Non-insulin glucose-lowering therapy under a start-stop protocol vs insulin-only therapy
- Group An = 582
- Group Bn = 397reference
- Outcome
- Safety: severe adverse events:
- Level 2-3 hypoglycaemia
- DKA
Methodological detailspragmatic, single tertiary hospital, multivariable logistic regression, propensity score matching
- Pragmatic
- Single tertiary hospital
- Multivariable logistic regression
- Propensity score matching
Main finding
As reported in the abstract
- Level 2-3 hypoglycaemia
- DKA
Severe adverse events in total, primarily hypoglycaemia
73
Non-insulin therapy independently associated with lower risk of severe adverse events: aOR
0.53 (0.29-0.97) (95% CI)
After propensity score matching, results consistent: OR
0.31 (0.15-0.61) (95% CI)
Observational data: associations, not effects.
Secondary outcomes
Median daily capillary glucose · lower with Group A
P < 0.001
Hospital stay (exploratory) · shorter with Group A
P < 0.001
Glycaemic variability
- Lower glycaemic variability in Group A
ICU admission and mortality (exploratory)
- No differences in ICU admission or mortality
Safety
- Severe adverse events, primarily hypoglycaemia
- 73
Original publication
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