Non-Insulin Antidiabetic Agents in the Management of Hyperglycaemia of Non-Critical Hospitalized Patients

Authors

  • Sofia Monteiro Lopes Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia, Diabetes e Metabolismo. Centro Hospitalar e Universitário de Coimbra. Coimbra. https://orcid.org/0009-0003-0410-0981
  • Ariana Maia Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia. Centro Hospitalar Universitário do Porto. Porto.
  • Pedro Melo Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia. Unidade Local de Saúde de Matosinhos. https://orcid.org/0000-0002-0156-2158
  • Silvestre Abreu Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço Regional de Saúde da Região Autónoma da Madeira. Funchal.
  • Isabel Paiva Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia, Diabetes e Metabolismo. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Luísa Barros Grupo de Estudos de Diabetes. Sociedade Portuguesa de Endocrinologia, Diabetes e Metabolismo. Lisboa; Serviço de Endocrinologia, Diabetes e Metabolismo. Centro Hospitalar e Universitário de Coimbra. Coimbra. https://orcid.org/0009-0006-6802-8888

DOI:

https://doi.org/10.20344/amp.20858

Keywords:

Diabetes Mellitus, Type 2/ drug therapy, Hyperglycemia/drug therapy, Hypoglycemia, Hypoglycemic Agents/therapeutic use

Abstract

Hyperglycaemia affects more than 30% of adults hospitalized for non-critical illness and is associated with an increased risk of adverse clinical outcomes. Insulin therapy is widely used for its safety and efficacy. However, given the growing availability of new drugs and new classes of antidiabetic agents with benefits beyond glycaemic control, challenges arise regarding their use in the hospital setting. This article aims to review and summarize the most recently available evidence and recommendations on the role of non-insulin antidiabetic agents in the management of hyperglycaemia in hospitalized patients. Insulin therapy remains the method of choice. Dipeptidyl peptidase 4 inhibitors can be considered in mild to moderate hyperglycaemia. Glucagon-like peptide 1 receptor agonists have recently shown promising results, with high efficacy in glycaemic control and low risk of hypoglycaemia. There are concerns regarding the increased risk of acidosis with metformin use, especially in cases of acute illness, although there is no evidence to support its suspension in selected patients with relative clinical stability. Sodium-glucose cotransporter-2 inhibitors should be discontinued in clinical situations that may predispose to ketoacidosis, including episodes of acute illness. The hospital use of sulfonylureas and thiazolidinediones is not advised.

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References

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Published

2024-02-05

How to Cite

1.
Monteiro Lopes S, Maia A, Melo P, Abreu S, Paiva I, Barros L. Non-Insulin Antidiabetic Agents in the Management of Hyperglycaemia of Non-Critical Hospitalized Patients. Acta Med Port [Internet]. 2024 Feb. 5 [cited 2024 Apr. 22];37(3):207-14. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20858

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Review Articles