Evidence map›Paper›PMID 32140422›Full record

ArticleJournal of clinical & translational endocrinology2020

Patterns and predictors of antihyperglycemic intensification at hospital discharge for type 2 diabetic patients not on home insulin.

Mohammed S Abusamaan, Betiel Fesseha Voss, Han Na Kim, Dalilah Reyes-DeJesus, Susan Langan, Timothy M Niessen, Nestoras N Mathioudakis

Abstract read
In one paragraph

Article in Journal of clinical & translational endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mohammed S AbusamaanDivision of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Betiel Fesseha VossDivision of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Han Na KimDivision of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Dalilah Reyes-DeJesusDivision of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Susan LanganDivision of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Timothy M NiessenDivision of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Nestoras N MathioudakisDivision of Endocrinology, Diabetes, & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Funding

JHU-UMD Diabetes Research CenterP30DK079637 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI WONDISFORD, FREDRIC E. · 2013 to 2017
$9.7M
Clinical Research&Epidemiology in Diabetes&EndocrinologyT32DK062707 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI TODD T BROWN, Wendy Lynet Bennett · 2002 to 2026
$7.3M
Implementation and Evaluation of a Real-Time Informatics Alert to Prevent Insulin-Associated Hypoglycemia in the HospitalK23DK111986 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI MATHIOUDAKIS, NESTORAS N · 2016 to 2019
$796k
NIDDK NIH HHS K23 DK111986NIDDK NIH HHS P30 DK079637NIDDK NIH HHS T32 DK062707
6 · The paper itself

Abstract

backgroundDiabetes mellitus is a prevalent condition among hospitalized patients and the inpatient setting presents an opportunity for providers to review and adjust antihyperglycemic medications. We sought to describe practice patterns and predictors of antihyperglycemic intensification (AHI) at hospital discharge for type 2 diabetes mellitus (T2DM) patients not on home insulin.

methodsWe conducted a retrospective study of adult patients with T2DM receiving either non-insulin antihyperglycemic (NIA) or no antihyperglycemic medications prior to admission who were hospitalized within two hospitals in the Johns Hopkins Health System from December 2015 to September 2016. Mean hospital glucose values and observed vs. individualized target hemoglobin A1C values (based on risk of mortality score) were used to define an indication for AHI. Multivariable logistic regression was used to identify predictors of AHI.

resultsA total of 554 discharges of 475 unique patients were included. An indication for AHI was present in 104 (18.8%) of discharges, and AHI occurred in 30 (28.8%) of these discharges. Higher mean admission BG values and A1C, fewer pre-admission antihyperglycemic agents, involvement of the diabetes service, and admitting service were associated with AHI, while no association was observed with age, sex, race, risk of mortality and severity of illness scores, or length of stay. AHI was not associated with 30-day readmission.

conclusionAn indication for AHI occurs relatively infrequently among hospitalized patients, but when present, AHI occurs in approximately 1 in 3 discharges. AHI appears to be related largely to the degree of hyperglycemia, and diabetes service involvement. Further studies are needed to understand the implications of AHI at hospital discharge on short and long-term outcomes in this population.

Indexed as

AntihyperglycemicClinical inertiaDiabetesIntensificationPredictor

Identifiers

PMID32140422
PMCPMC7049656

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.