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Title: The comparative epidemiology and outcomes of hospitalized patients treated with SGLT2 or DPP4 inhibitors.
Austin Authors: Huang, Warren ;Whitelaw, Jack;Kishore, Kartik ;Neto, Ary Serpa;Holmes, Natasha E ;Marhoon, Nada ;Bellomo, Rinaldo ;Ekinci, Elif I 
Affiliation: Data Analytics Research and Evaluation (DARE) Centre..
Intensive Care
Department of Medicine, The University of Melbourne, Melbourne, Australia..
School of Medicine, The University of Melbourne, Melbourne, Australia.
Infectious Diseases
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil..
Department of Critical Care, The University of Melbourne, Melbourne, Australia..
Australian and New Zealand Intensive Care Research Centre Monash University, Melbourne, Australia..
Issue Date: Dec-2021
Date: 2021-09-27
Publication information: Journal of Diabetes and Its Complications 2021; 35(12): 108052
Abstract: To compare the outcomes of sodium glucose linked cotransporter 2 inhibitors (SGLT2i) and dipeptidyl peptidase 4 inhibitors (DPP4i) in hospitalized patients. Electronic medical records-based cohort study. Identification of patients with type 2 diabetes and treatment with SGLT2i (n = 466) or DPP4i (n = 1541). Outcomes compared between those who received SGLT2i and those who received DPP4i. The primary outcome: adjusted percentage of blood glycemia within 4-10 mmol/L. After adjustment, SGLT2i use had a statistically equivalent percentage of glycemia within range (coefficient: 4.55, 95% CI -3.23 to 12.32, p = 0.25) or <4 mmol/L (coefficient -0.17, 95% CI -0.71 to 3.72, p = 0.54). There were no significant differences in hospital length of stay (p = 0.22), complications, (p = 0.11) or mortality (p = 0.57). When measured, ketone levels were higher in the SGLT2i group on admission, but lower on days 3, 4 and 5 (p < 0.001 for interaction). Bicarbonate levels were not statistically different between groups. Finally, 54% of patients whose SGLT2i was ceased during admission, were discharged home without it. Among inpatients with type 2 diabetes, SGLT2i use was associated with equivalent within-target glycaemia and no significant increase in hypoglycemia, ketonemia, or lower bicarbonate levels. These hypothesis-generating findings support further investigation of SGLT2i therapy in inpatients.
DOI: 10.1016/j.jdiacomp.2021.108052
ORCID: 0000-0002-1650-8939
Journal: Journal of Diabetes and Its Complications
PubMed URL: 34600824
PubMed URL:
Type: Journal Article
Subjects: Complications
Appears in Collections:Journal articles

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