Journal of diabetes and its complications

Factors linked to hospital use of two diabetes medicines in adults

Updated

Abstract

Only 3.7% of patients hospitalized with type 2 diabetes mellitus received a sodium-glucose cotransporter 2 inhibitor (SGLT2) prior to discharge.

  • Patients with hemoglobin A1C levels greater than 9.0% were associated with a higher likelihood of receiving an SGLT2 (Odds Ratio = 1.81).
  • Individuals aged 40-60 years were also more likely to receive novel diabetes medications compared to those under 40 (Odds Ratio = 1.81).
  • Dementia was associated with a lower likelihood of receiving novel diabetes medications (Odds Ratio = 0.47).
  • Elevated creatinine levels (≥200 μmol/L) were linked to a significantly reduced chance of receiving these medications (Odds Ratio = 0.11).
  • Nearly 47% of patients hospitalized with type 2 diabetes not receiving a novel medication could potentially benefit from an SGLT2 inhibitor.

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Full Text

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Funding

Competing interests

Declaration of competing interest Michael Fralick was a consultant for ProofDx, a start-up company creating a point of care diagnostic test for COVID-19. Michael Fralick is an advisor for SIGNAL1, a start-up company deploying machine learned models to improve inpatient care. Tor Biering-Sørensen discloses the following relationships: steering committee member of the Amgen-financed GALACTIC-HF trial, of the Boehringer Ingelheim financed SHARP3 trial, of “LUX-Dx TRENDS Evaluates Diagnostics Sensors in Heart Failure Patients Receiving Boston Scientific's Investigational ICM System” trial; advisory board: Amgen, CSL Seqirus and GSK; chief investigator of the Sanofi Pasteur financed “NUDGE-FLU”, “DANFLU-1”, and “DANFLU-2” trials; speaker honorarium: Bayer, Novartis, Sanofi Pasteur, GE healthcare and GSK; consultant appointments: Novo Nordisk, IQVIA and Parexel; and research grants: GE Healthcare, AstraZeneca, Novo Nordisk and Sanofi Pasteur. Fahad Razak is a part-time employee of Ontario Health. The development of the GEMINI data platform has been supported with funding from sources such as the Canadian Cancer Society, the Canadian Frailty Network, the Canadian Institutes of Health Research, the Canadian Medical Protective Agency, Green Shield Canada Foundation, the Natural Sciences and Engineering Research Council of Canada, Ontario Health, the St. Michael's Hospital Association Innovation Fund, the University of Toronto Department of Medicine, and in-kind support from partner hospitals and the Vector Institute. Fahad Razak holds a salary award from Canada Research Chairs Program, University of Toronto and the PSI Graham Farquharson Knowledge Translation Fellowship. No funding sources from Fahad Razak influenced the writing of this manuscript. Outside of the submitted work, Amol Verma is a part-time employee of Ontario Health and a co-inventor of an AI-based early warning system for patient deterioration that was acquired by the start-up company Signal1. Magnus Thorsten Jensen is the CEO of Steno Diabetes Center Copenhagen which is funded through a partnership between the Capital Region of Denmark and the Novo Nordisk Foundation. Bruce A. Perkins has received honoraria for educational events from Medtronic, Novo Nordisk, Sanofi, Insulet and Abbott. His research institute has received funding from BMO Bank of Montreal and Novo Nordisk for research support. He has served as an advisor to Boehringer Ingelheim, Sanofi, Insulet, Abbott, and Vertex. Ashley Raudanskis, Shohinee Sarma, Katarina Zorcic, and Michael Colacci have no reported conflicts of interest.
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