Smita Kumar1, Mark E Molitch2. 1. Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave., Suite 530, Chicago, IL, 60611, USA. 2. Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave., Suite 530, Chicago, IL, 60611, USA. molitch@northwestern.edu.
Abstract
PURPOSE OF REVIEW: Insulin has been the standard of care for the management of inpatient diabetes for achieving strict glycemic control. This review supports continuing insulin therapy for hyperglycemic management in the hospital compared with the use of non-insulin treatment regimens. RECENT FINDINGS: Oral hypoglycemic agents and glucagon-like peptide 1 (GLP-1) receptor agonists have typically not been used in the inpatient setting. Recent studies regarding DPP-4 inhibitors have led to variable results with fairly high glycemic values during the hospitalization. Similarly, studies looking at GLP-1 receptor agonists are limited, but gastrointestinal side effects limit their inpatient use. Overall, there is a paucity of data to support the use of non-insulin-based therapy in the inpatient setting. Insulin has repeatedly demonstrated that its advantageous quality of being easily titratable leads to more consistently efficacious glycemic control that improves morbidity and mortality.
PURPOSE OF REVIEW: Insulin has been the standard of care for the management of inpatient diabetes for achieving strict glycemic control. This review supports continuing insulin therapy for hyperglycemic management in the hospital compared with the use of non-insulin treatment regimens. RECENT FINDINGS: Oral hypoglycemic agents and glucagon-like peptide 1 (GLP-1) receptor agonists have typically not been used in the inpatient setting. Recent studies regarding DPP-4 inhibitors have led to variable results with fairly high glycemic values during the hospitalization. Similarly, studies looking at GLP-1 receptor agonists are limited, but gastrointestinal side effects limit their inpatient use. Overall, there is a paucity of data to support the use of non-insulin-based therapy in the inpatient setting. Insulin has repeatedly demonstrated that its advantageous quality of being easily titratable leads to more consistently efficacious glycemic control that improves morbidity and mortality.
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