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Poster #769 360 4K EASD 2018

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Guillermo Umpierrez

Thank you i don’t know how many of you do inpatient diabetes care but guidelines in the united states in europe recommend the use of insulin at the only way to treating patients in the hospital but we know that about half of the patients around the world in the hospital are treated with oral agents so there in the last five years we have published several data with

Other dpp force we decided to conduct these studies in surgical patients so the general surgery patient is noncardiac a to randomize them to linagliptin one tablet that doesn’t need to be adjusted for kidney function or to distend their basil basil bolus product so we took patients over the age of help between the ages of 18 to 80 they were treated with diet oil

Agents for low dose insulin up 2.5 units per kilo so somebody like me up to 40 units and we randomized one group got linagliptin the other group was basil basil paulo’s both group received correction if the bloke look over sprayed at 140 and we’ve got 280 patients at the end we end up by about 130 pretty group the vinegar characteristic was very similar typical

For in the united states bmi about 32 unfortunately these patients were avid length of taste about fourth to four days as a median the duration of diabetes was about 8 to 10 years and they were treated with all kind of oral agents basically where they find it so insulin that a little better glucose as you may expect so the average blood sugar was 171 with for the

Linagliptin and 159 so the different was 11 milligrams so you know over 1mill of more and this is the glucose levels if you divide the data because less than 200 or over 200 so in surgical patient this were four universities in the united states the 66 percent of patient had a blood glucose less than 200 milligrams per year 66 2/3 and if you divide them there is no

Difference in outcome so this is very similar to what published before if you ever going to use oral agents in the hospital make sure that the blog look was not greater than 200 if not insulin it’s much much better of course linagliptin was associated with less hypoglycemia this is less than 7 and less than 54 what is now spiracle as significant was significantly

Less with the linagliptin we followed this patient there in the hospital there is no difference in complications no difference in mental state no difference in any one of the parameters that we observe we followed this patient for three months after discharge and here you have the patient were following according to linda gibson and the patient did fairly well

The hemoglobin a1c was first to 7.2 and the majority of pace i had a hemoglobin a1c less than 8 so in summary what we have learned with this and our previous work and others published in the literature is that all agents are used in the hospital dpp-4 are useful if the blood glucose less than 180 to 200 above that you should treat this patient with basic policy

Insulin therapy you may reduce the risk of hypoglycemia

Transcribed from video
Poster #769 360° 4K EASD 2018 By European Association for the Study of Diabetes