Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with type 2 diabetes: randomised controlled trial (Dapa-Hospital trial)
Aims To examine the efficacy and safety of dapagliflozin in the treatment of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D). Methods Cardiac surgery patients with T2D ( n = 250) were randomly assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA group) or basa...
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| Veröffentlicht in: | Acta diabetologica 2023-11, Vol.60 (11), p.1481-1490 |
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| creator | Kuchay, Mohammad Shafi Khatana, Pushpender Mishra, Mitali Surendran, Parvathi Kaur, Parjeet Wasir, Jasjeet Singh Gill, Harmandeep Kaur Singh, Apanshu Jain, Rujul Kohli, Chhavi Bakshi, Gazal Radhika, Vishnupriya Saheer, Sumayya Singh, Manish Kumar Mishra, Sunil Kumar |
| description | Aims
To examine the efficacy and safety of dapagliflozin in the treatment of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D).
Methods
Cardiac surgery patients with T2D (
n
= 250) were randomly assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA group) or basal-bolus insulin alone (INSULIN group) in the early postoperative period. The primary outcome was mean difference in daily blood glucose (BG) concentrations between groups. The major safety outcomes were the occurrence of severe ketonemia/diabetic ketoacidosis (DKA) and hypoglycemia. All analyses were performed according to the intention-to-treat principle.
Results
The median age of the patients was 61 years (range, 55–61), and 219 (87.6%) were men. Overall, the randomization blood glucose was 165 mg/dL (SD, 37) and glycated hemoglobin was 7.7% (SD, 1.4). There were no differences in mean daily BG concentrations (149 vs. 150 mg/dL), mean percentage of readings within target BG of 70–180 mg/dL (82.7% vs. 82.5%), total daily insulin dose (mean, 39 vs. 40 units/day), number of daily insulin injections (median, 3.9 vs. 4), length of hospital stay (median, 10 vs. 10 days), or hospital complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. The mean plasma ketone levels were significantly higher in the DAPA group than in the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs. 0.19 mmol/L) of randomization. Six patients in the DAPA group developed severe ketonemia, but no patient developed DKA. There were no differences in the proportion of patients with BG |
| doi_str_mv | 10.1007/s00592-023-02138-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2831299735</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2831299735</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-c00930fbb5708c8bb9670518e0fed59ec066cb1a5e23f98663645b49bca1d4c93</originalsourceid><addsrcrecordid>eNp9kUtuFDEQhi1ERB5wARbIEpuw6OBHu9tmhwIhSJHYwNqy3dUTR552Y7sVDYfgDJyFk-Ghh4dYsLCqVP7qr1L9CD2l5IIS0r_MhAjFGsJ4fZTLpn2ATmjLWSMY5w__yo_Rac53hFDWc_kIHfMaSM_kCfr6xsxmE_wY4hc_4TEm7KfZFA9Twbe7GdIm7Bxsval17EwavHE4L2kDaYcPYMb3vtziUnHMcCUsFMivcDLTELc-w4BdnEqKIdS0JG_C92_n-8nNdcyzLyas1ReP0dFoQoYnh3iGPl29_Xh53dx8ePf-8vVN43gvSuMIUZyM1oqeSCetVV1PBJVARhiEAke6zllqBDA-Ktl1vGuFbZV1hg6tU_wMna-6c4qfF8hF1zUdhGAmiEvWTHLKlOq5qOjzf9C7uKSpblepTvZif8tKsZVyKeacYNRz8luTdpoSvXdLr27p6pb-6ZZua9Ozg_RitzD8bvllTwX4CuT6NdWT_5n9H9kfyXeiig</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2868757380</pqid></control><display><type>article</type><title>Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with type 2 diabetes: randomised controlled trial (Dapa-Hospital trial)</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kuchay, Mohammad Shafi ; Khatana, Pushpender ; Mishra, Mitali ; Surendran, Parvathi ; Kaur, Parjeet ; Wasir, Jasjeet Singh ; Gill, Harmandeep Kaur ; Singh, Apanshu ; Jain, Rujul ; Kohli, Chhavi ; Bakshi, Gazal ; Radhika, Vishnupriya ; Saheer, Sumayya ; Singh, Manish Kumar ; Mishra, Sunil Kumar</creator><creatorcontrib>Kuchay, Mohammad Shafi ; Khatana, Pushpender ; Mishra, Mitali ; Surendran, Parvathi ; Kaur, Parjeet ; Wasir, Jasjeet Singh ; Gill, Harmandeep Kaur ; Singh, Apanshu ; Jain, Rujul ; Kohli, Chhavi ; Bakshi, Gazal ; Radhika, Vishnupriya ; Saheer, Sumayya ; Singh, Manish Kumar ; Mishra, Sunil Kumar</creatorcontrib><description>Aims
To examine the efficacy and safety of dapagliflozin in the treatment of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D).
Methods
Cardiac surgery patients with T2D (
n
= 250) were randomly assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA group) or basal-bolus insulin alone (INSULIN group) in the early postoperative period. The primary outcome was mean difference in daily blood glucose (BG) concentrations between groups. The major safety outcomes were the occurrence of severe ketonemia/diabetic ketoacidosis (DKA) and hypoglycemia. All analyses were performed according to the intention-to-treat principle.
Results
The median age of the patients was 61 years (range, 55–61), and 219 (87.6%) were men. Overall, the randomization blood glucose was 165 mg/dL (SD, 37) and glycated hemoglobin was 7.7% (SD, 1.4). There were no differences in mean daily BG concentrations (149 vs. 150 mg/dL), mean percentage of readings within target BG of 70–180 mg/dL (82.7% vs. 82.5%), total daily insulin dose (mean, 39 vs. 40 units/day), number of daily insulin injections (median, 3.9 vs. 4), length of hospital stay (median, 10 vs. 10 days), or hospital complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. The mean plasma ketone levels were significantly higher in the DAPA group than in the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs. 0.19 mmol/L) of randomization. Six patients in the DAPA group developed severe ketonemia, but no patient developed DKA. There were no differences in the proportion of patients with BG < 70 mg/dL (9.6% vs. 7.2%) between the two groups.
Conclusion
Dapagliflozin complementary to basal-bolus insulin does not improve glycemia further over and above the basal-bolus insulin alone in hospitalized cardiac surgery patients. Dapagliflozin significantly increases plasma ketones levels. Safety of dapagliflozin in hospitalized patients needs further investigation.
Trial registration
ClinicalTrials.gov NCT05457933.</description><identifier>ISSN: 1432-5233</identifier><identifier>ISSN: 0940-5429</identifier><identifier>EISSN: 1432-5233</identifier><identifier>DOI: 10.1007/s00592-023-02138-4</identifier><identifier>PMID: 37380728</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Antidiabetics ; Blood Glucose ; Cardiac Surgical Procedures ; Diabetes ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - surgery ; Diabetic Ketoacidosis - drug therapy ; Female ; Heart ; Heart surgery ; Hemoglobin ; Hospitals ; Humans ; Hyperglycemia ; Hyperglycemia - drug therapy ; Hyperglycemia - etiology ; Hypoglycemia ; Hypoglycemic Agents - therapeutic use ; Inpatients ; Insulin ; Insulin - therapeutic use ; Internal Medicine ; Ketoacidosis ; Ketones ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Middle Aged ; Original Article ; Patients ; Safety ; Treatment Outcome</subject><ispartof>Acta diabetologica, 2023-11, Vol.60 (11), p.1481-1490</ispartof><rights>Springer-Verlag Italia S.r.l., part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Springer-Verlag Italia S.r.l., part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c00930fbb5708c8bb9670518e0fed59ec066cb1a5e23f98663645b49bca1d4c93</citedby><cites>FETCH-LOGICAL-c375t-c00930fbb5708c8bb9670518e0fed59ec066cb1a5e23f98663645b49bca1d4c93</cites><orcidid>0000-0003-3933-6137</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00592-023-02138-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00592-023-02138-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,782,786,27931,27932,41495,42564,51326</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37380728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kuchay, Mohammad Shafi</creatorcontrib><creatorcontrib>Khatana, Pushpender</creatorcontrib><creatorcontrib>Mishra, Mitali</creatorcontrib><creatorcontrib>Surendran, Parvathi</creatorcontrib><creatorcontrib>Kaur, Parjeet</creatorcontrib><creatorcontrib>Wasir, Jasjeet Singh</creatorcontrib><creatorcontrib>Gill, Harmandeep Kaur</creatorcontrib><creatorcontrib>Singh, Apanshu</creatorcontrib><creatorcontrib>Jain, Rujul</creatorcontrib><creatorcontrib>Kohli, Chhavi</creatorcontrib><creatorcontrib>Bakshi, Gazal</creatorcontrib><creatorcontrib>Radhika, Vishnupriya</creatorcontrib><creatorcontrib>Saheer, Sumayya</creatorcontrib><creatorcontrib>Singh, Manish Kumar</creatorcontrib><creatorcontrib>Mishra, Sunil Kumar</creatorcontrib><title>Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with type 2 diabetes: randomised controlled trial (Dapa-Hospital trial)</title><title>Acta diabetologica</title><addtitle>Acta Diabetol</addtitle><addtitle>Acta Diabetol</addtitle><description>Aims
To examine the efficacy and safety of dapagliflozin in the treatment of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D).
Methods
Cardiac surgery patients with T2D (
n
= 250) were randomly assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA group) or basal-bolus insulin alone (INSULIN group) in the early postoperative period. The primary outcome was mean difference in daily blood glucose (BG) concentrations between groups. The major safety outcomes were the occurrence of severe ketonemia/diabetic ketoacidosis (DKA) and hypoglycemia. All analyses were performed according to the intention-to-treat principle.
Results
The median age of the patients was 61 years (range, 55–61), and 219 (87.6%) were men. Overall, the randomization blood glucose was 165 mg/dL (SD, 37) and glycated hemoglobin was 7.7% (SD, 1.4). There were no differences in mean daily BG concentrations (149 vs. 150 mg/dL), mean percentage of readings within target BG of 70–180 mg/dL (82.7% vs. 82.5%), total daily insulin dose (mean, 39 vs. 40 units/day), number of daily insulin injections (median, 3.9 vs. 4), length of hospital stay (median, 10 vs. 10 days), or hospital complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. The mean plasma ketone levels were significantly higher in the DAPA group than in the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs. 0.19 mmol/L) of randomization. Six patients in the DAPA group developed severe ketonemia, but no patient developed DKA. There were no differences in the proportion of patients with BG < 70 mg/dL (9.6% vs. 7.2%) between the two groups.
Conclusion
Dapagliflozin complementary to basal-bolus insulin does not improve glycemia further over and above the basal-bolus insulin alone in hospitalized cardiac surgery patients. Dapagliflozin significantly increases plasma ketones levels. Safety of dapagliflozin in hospitalized patients needs further investigation.
Trial registration
ClinicalTrials.gov NCT05457933.</description><subject>Antidiabetics</subject><subject>Blood Glucose</subject><subject>Cardiac Surgical Procedures</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - surgery</subject><subject>Diabetic Ketoacidosis - drug therapy</subject><subject>Female</subject><subject>Heart</subject><subject>Heart surgery</subject><subject>Hemoglobin</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hyperglycemia - drug therapy</subject><subject>Hyperglycemia - etiology</subject><subject>Hypoglycemia</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Inpatients</subject><subject>Insulin</subject><subject>Insulin - therapeutic use</subject><subject>Internal Medicine</subject><subject>Ketoacidosis</subject><subject>Ketones</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolic Diseases</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Patients</subject><subject>Safety</subject><subject>Treatment Outcome</subject><issn>1432-5233</issn><issn>0940-5429</issn><issn>1432-5233</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtuFDEQhi1ERB5wARbIEpuw6OBHu9tmhwIhSJHYwNqy3dUTR552Y7sVDYfgDJyFk-Ghh4dYsLCqVP7qr1L9CD2l5IIS0r_MhAjFGsJ4fZTLpn2ATmjLWSMY5w__yo_Rac53hFDWc_kIHfMaSM_kCfr6xsxmE_wY4hc_4TEm7KfZFA9Twbe7GdIm7Bxsval17EwavHE4L2kDaYcPYMb3vtziUnHMcCUsFMivcDLTELc-w4BdnEqKIdS0JG_C92_n-8nNdcyzLyas1ReP0dFoQoYnh3iGPl29_Xh53dx8ePf-8vVN43gvSuMIUZyM1oqeSCetVV1PBJVARhiEAke6zllqBDA-Ktl1vGuFbZV1hg6tU_wMna-6c4qfF8hF1zUdhGAmiEvWTHLKlOq5qOjzf9C7uKSpblepTvZif8tKsZVyKeacYNRz8luTdpoSvXdLr27p6pb-6ZZua9Ozg_RitzD8bvllTwX4CuT6NdWT_5n9H9kfyXeiig</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Kuchay, Mohammad Shafi</creator><creator>Khatana, Pushpender</creator><creator>Mishra, Mitali</creator><creator>Surendran, Parvathi</creator><creator>Kaur, Parjeet</creator><creator>Wasir, Jasjeet Singh</creator><creator>Gill, Harmandeep Kaur</creator><creator>Singh, Apanshu</creator><creator>Jain, Rujul</creator><creator>Kohli, Chhavi</creator><creator>Bakshi, Gazal</creator><creator>Radhika, Vishnupriya</creator><creator>Saheer, Sumayya</creator><creator>Singh, Manish Kumar</creator><creator>Mishra, Sunil Kumar</creator><general>Springer Milan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3933-6137</orcidid></search><sort><creationdate>20231101</creationdate><title>Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with type 2 diabetes: randomised controlled trial (Dapa-Hospital trial)</title><author>Kuchay, Mohammad Shafi ; Khatana, Pushpender ; Mishra, Mitali ; Surendran, Parvathi ; Kaur, Parjeet ; Wasir, Jasjeet Singh ; Gill, Harmandeep Kaur ; Singh, Apanshu ; Jain, Rujul ; Kohli, Chhavi ; Bakshi, Gazal ; Radhika, Vishnupriya ; Saheer, Sumayya ; Singh, Manish Kumar ; Mishra, Sunil Kumar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c00930fbb5708c8bb9670518e0fed59ec066cb1a5e23f98663645b49bca1d4c93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antidiabetics</topic><topic>Blood Glucose</topic><topic>Cardiac Surgical Procedures</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - surgery</topic><topic>Diabetic Ketoacidosis - drug therapy</topic><topic>Female</topic><topic>Heart</topic><topic>Heart surgery</topic><topic>Hemoglobin</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hyperglycemia - drug therapy</topic><topic>Hyperglycemia - etiology</topic><topic>Hypoglycemia</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Inpatients</topic><topic>Insulin</topic><topic>Insulin - therapeutic use</topic><topic>Internal Medicine</topic><topic>Ketoacidosis</topic><topic>Ketones</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metabolic Diseases</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Patients</topic><topic>Safety</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kuchay, Mohammad Shafi</creatorcontrib><creatorcontrib>Khatana, Pushpender</creatorcontrib><creatorcontrib>Mishra, Mitali</creatorcontrib><creatorcontrib>Surendran, Parvathi</creatorcontrib><creatorcontrib>Kaur, Parjeet</creatorcontrib><creatorcontrib>Wasir, Jasjeet Singh</creatorcontrib><creatorcontrib>Gill, Harmandeep Kaur</creatorcontrib><creatorcontrib>Singh, Apanshu</creatorcontrib><creatorcontrib>Jain, Rujul</creatorcontrib><creatorcontrib>Kohli, Chhavi</creatorcontrib><creatorcontrib>Bakshi, Gazal</creatorcontrib><creatorcontrib>Radhika, Vishnupriya</creatorcontrib><creatorcontrib>Saheer, Sumayya</creatorcontrib><creatorcontrib>Singh, Manish Kumar</creatorcontrib><creatorcontrib>Mishra, Sunil Kumar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Acta diabetologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kuchay, Mohammad Shafi</au><au>Khatana, Pushpender</au><au>Mishra, Mitali</au><au>Surendran, Parvathi</au><au>Kaur, Parjeet</au><au>Wasir, Jasjeet Singh</au><au>Gill, Harmandeep Kaur</au><au>Singh, Apanshu</au><au>Jain, Rujul</au><au>Kohli, Chhavi</au><au>Bakshi, Gazal</au><au>Radhika, Vishnupriya</au><au>Saheer, Sumayya</au><au>Singh, Manish Kumar</au><au>Mishra, Sunil Kumar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with type 2 diabetes: randomised controlled trial (Dapa-Hospital trial)</atitle><jtitle>Acta diabetologica</jtitle><stitle>Acta Diabetol</stitle><addtitle>Acta Diabetol</addtitle><date>2023-11-01</date><risdate>2023</risdate><volume>60</volume><issue>11</issue><spage>1481</spage><epage>1490</epage><pages>1481-1490</pages><issn>1432-5233</issn><issn>0940-5429</issn><eissn>1432-5233</eissn><abstract>Aims
To examine the efficacy and safety of dapagliflozin in the treatment of hyperglycemia in cardiac surgery patients with type 2 diabetes (T2D).
Methods
Cardiac surgery patients with T2D (
n
= 250) were randomly assigned (1:1) to receive dapagliflozin plus basal-bolus insulin (DAPA group) or basal-bolus insulin alone (INSULIN group) in the early postoperative period. The primary outcome was mean difference in daily blood glucose (BG) concentrations between groups. The major safety outcomes were the occurrence of severe ketonemia/diabetic ketoacidosis (DKA) and hypoglycemia. All analyses were performed according to the intention-to-treat principle.
Results
The median age of the patients was 61 years (range, 55–61), and 219 (87.6%) were men. Overall, the randomization blood glucose was 165 mg/dL (SD, 37) and glycated hemoglobin was 7.7% (SD, 1.4). There were no differences in mean daily BG concentrations (149 vs. 150 mg/dL), mean percentage of readings within target BG of 70–180 mg/dL (82.7% vs. 82.5%), total daily insulin dose (mean, 39 vs. 40 units/day), number of daily insulin injections (median, 3.9 vs. 4), length of hospital stay (median, 10 vs. 10 days), or hospital complications (21.6% vs. 24.8%) between the DAPA and INSULIN groups. The mean plasma ketone levels were significantly higher in the DAPA group than in the INSULIN group at day 3 (0.71 vs. 0.30 mmol/L) and day 5 (0.42 vs. 0.19 mmol/L) of randomization. Six patients in the DAPA group developed severe ketonemia, but no patient developed DKA. There were no differences in the proportion of patients with BG < 70 mg/dL (9.6% vs. 7.2%) between the two groups.
Conclusion
Dapagliflozin complementary to basal-bolus insulin does not improve glycemia further over and above the basal-bolus insulin alone in hospitalized cardiac surgery patients. Dapagliflozin significantly increases plasma ketones levels. Safety of dapagliflozin in hospitalized patients needs further investigation.
Trial registration
ClinicalTrials.gov NCT05457933.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>37380728</pmid><doi>10.1007/s00592-023-02138-4</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3933-6137</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-5233 |
| ispartof | Acta diabetologica, 2023-11, Vol.60 (11), p.1481-1490 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Antidiabetics Blood Glucose Cardiac Surgical Procedures Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - surgery Diabetic Ketoacidosis - drug therapy Female Heart Heart surgery Hemoglobin Hospitals Humans Hyperglycemia Hyperglycemia - drug therapy Hyperglycemia - etiology Hypoglycemia Hypoglycemic Agents - therapeutic use Inpatients Insulin Insulin - therapeutic use Internal Medicine Ketoacidosis Ketones Male Medicine Medicine & Public Health Metabolic Diseases Middle Aged Original Article Patients Safety Treatment Outcome |
| title | Dapagliflozin for inpatient hyperglycemia in cardiac surgery patients with type 2 diabetes: randomised controlled trial (Dapa-Hospital trial) |
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