Evidence map›Paper›PMID 41913157›Full record

Trial reportCardiovascular diabetology2026

Inpatient safety, effectiveness of SGLT2 inhibitors and GLP-1 RAs in type 2 diabetes: ENDOCARE, a pragmatic prospective cohort study.

Óscar Moreno-Pérez, Antonio Tejera-Muñoz, Nuria Leiva-Mora, Elisa Santacruz, Ruth Sánchez-Ortiga, Vicente Arrarte, Eduardo Climent-Grana, Miriam Sandin, Gerónima Riera, Pedro Lopez-Mondejar and 9 more

Abstract readPragmatic Clinical Trial
In one paragraph

Trial report in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

19 authors.

Óscar Moreno-Pérez *Department of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain. omorenoperez@hotmail.es.
Antonio Tejera-Muñoz *Department of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Nuria Leiva-MoraDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Elisa SantacruzDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Ruth Sánchez-OrtigaDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Vicente ArrarteDepartment of Clinical Medicine, Miguel Hernández University, Elche, Spain.
Eduardo Climent-GranaDepartment of Pharmacy, General University Hospital Dr. Balmis of Alicante. Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Alicante, Spain.
Miriam SandinDepartment of Cardiology, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Alicante, Spain.
Gerónima RieraDepartment of Pharmacy, General University Hospital Dr. Balmis of Alicante. Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Alicante, Spain.
Pedro Lopez-MondejarDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Beatriz López-MuñozDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Clara NavarroDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Cristina Guillen-MoroteDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Ada Roldán-SánchezDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Myriam Sánchez-PachecoDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Ángel Luis Abad-GonzálezDepartment of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Pere LlorensEmergency Department, Short Stay Unit and Hospitalization at Home Unit, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, Alicante, Spain.
Antonio Pico-Alfonso *Department of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.
Joaquín Serrano-Gotarredona *Department of Endocrinology and Nutrition, General University Hospital Dr. Balmis of Alicante, Institute of Health and Biomedical Research of Alicante (ISABIAL), Alicante, C/ Pintor Baeza S/N. CP 03010, Alicante, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent guidelines recommend baseline insulin as the standard treatment for most people hospitalised with type 2 diabetes (PWT2D). However, they generally discourage the use of sodium–glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists due to safety concerns and a lack of randomised evidence. We aim to assess primarily safety, and secondarily, effectiveness of non-insulin glucose-lowering therapy for inpatients, as implemented within a structured start-stop clinical practice guideline.

methodsWe conducted a 9-month pragmatic prospective cohort study including PWT2D adults who were admitted to the medical and surgical wards of a tertiary hospital. Participants were managed either on oral antidiabetic drugs (with or without insulin) under a start–stop protocol (Group A) or with insulin-only therapy (Group B). The primary outcome was safety, defined as severe adverse events (level 2–3 hypoglycaemia or diabetic ketoacidosis). Secondary outcomes included median daily capillary glucose and glycaemic variability. Hospital stay, intensive care unit admission and mortality were exploratory outcomes. Multivariable logistic regression and propensity score matching were employed to adjust for confounding factors.

resultsA total of 979 participants were included in the study: 582 in the Group A and 397 in the Group B. Seventy-three severe adverse events occurred, primarily hypoglycaemia. Non-insulin therapy was independently associated with a lower risk of severe adverse events (aOR 0.53 [95%CI 0.29–0.97]), and these results remained consistent after propensity score matching (OR 0.31 [95%CI 0.15–0.61]). The Group A had a lower median daily glucose level (153 mg/dL vs. 179 mg/dL; p < 0.001), lower glycaemic variability and a shorter hospital stay (5 days vs. 7 days; p < 0.001). No differences were observed in intensive care unit admission or mortality.

conclusionsIn 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.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsGlycemic ControlIncretinsInpatientsInsulinSodium-Glucose Transporter 2 InhibitorsAdministration, OralAgedBiomarkersDiabetic KetoacidosisDrug Therapy, CombinationFemaleGlucagon-Like Peptide-1 ReceptorHumansBiomarkersBlood GlucoseGLP1R protein, humanGlucagon-Like Peptide-1 ReceptorGlucagon-Like Peptide-1 Receptor AgonistsIncretinsInsulinSodium-Glucose Transporter 2 InhibitorsGLP-1 receptor agonistsGuidelineHospitalInpatientsOral semaglutideProspective studyReal world evidenceSGLT2 inhibitorsType 2 diabetes

Identifiers

PMID41913157
PMCPMC13126886

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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.