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Advisor(s)
Abstract(s)
Type 2 diabetes mellitus (T2DM) is closely associated with other pathologies, which may
require complex therapeutic approaches. We aim to characterize the clinical and pharmacological
profile of T2DM patients admitted to an emergency department. Patients aged ≥65 years and who were
already using at least one antidiabetic drug were included in this analysis. Blood glycemia, creatinine,
aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hemoglobin were analyzed
for each patient, as well as personal pathological history, diagnosis(s) at admission, and antidiabetic
drugs used before. Outcome variables were analyzed using Pearson’s Chi-Square, Fisher’s exact test,
and linear regression test. In total, 420 patients were randomly selected (48.6% male and 51.4% female).
Patients with family support showed a lower incidence of high glycemia at admission (p = 0.016). Higher
blood creatinine levels were associated with higher blood glycemia (p = 0.005), and hyperuricemia (HU)
(p = 0.001), as well as HU, was associated with a higher incidence of acute cardiovascular diseases (ACD)
(p = 0.007). Hemoglobin levels are lower with age (p = 0.0001), creatinine (p = 0.009), and female gender
(p = 0.03). The lower the AST/ALT ratio, the higher the glycemia at admission (p < 0.0001). Obese
patients with (p = 0.021) or without (p = 0.027) concomitant dyslipidemia had a higher incidence of ACD.
Insulin (p = 0.003) and glucagon-like peptide-1 agonists (GLP1 RA) (p = 0.023) were associated with a
higher incidence of decompensated heart failure, while sulfonylureas (p = 0.009), metformin-associated
with dipeptidyl peptidase-4 inhibitors (DPP4i) (p = 0.029) or to a sulfonylurea (p = 0.003) with a lower
incidence. Metformin, in monotherapy or associated with DPP4i, was associated with a lower incidence
of acute kidney injury (p = 0.017) or acute chronic kidney injury (p = 0.014). SGLT2i monotherapy
(p = 0.0003), associated with metformin (p = 0.026) or with DPP4i (p = 0.007), as well as insulin and
sulfonylurea association (p = 0.026), were associated with hydroelectrolytic disorders, unlike GLP1 RA
(p = 0.017), DPP4i associated with insulin (p = 0.034) or with a GLP1 RA (p = 0.003). Insulin was mainly
used by autonomous and institutionalized patients (p = 0.0008), while metformin (p = 0.003) and GLP1
RA (p < 0.0001) were used by autonomous patients. Sulfonylureas were mostly used by male patients
(p = 0.027), while SGLT2 (p = 0.0004) and GLP1 RA (p < 0.0001) were mostly used by patients within the
age group 65-85 years. Sulfonylureas (p = 0.008), insulin associated with metformin (p = 0.040) or with
a sulfonylurea (p = 0.048), as well as DPP4i and sulfonylurea association (p = 0.031), were associated
with higher blood glycemia. T2DM patients are characterized by great heterogeneity from a clinical
point of view presenting with several associated comorbidities, so the pharmacotherapeutic approach
must consider all aspects that may affect disease progression.
Description
Keywords
Type 2 diabetes mellitus Cardiovascular disorders Glycemia Kidney function