Hypoglycemia as a medication‑related harm identified in patients admitted to geriatric wards

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064190%3A_____%2F21%3AN0000144" target="_blank" >RIV/00064190:_____/21:N0000144 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064203:_____/21:10426313 RIV/00216208:11130/21:10426313

Výsledek na webu

<a href="http://pamw.pl/en/node/15905/pdf" target="_blank" >http://pamw.pl/en/node/15905/pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.20452/pamw.15905" target="_blank" >10.20452/pamw.15905</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Hypoglycemia as a medication‑related harm identified in patients admitted to geriatric wards

Popis výsledku v původním jazyce

To the editor The article by Bień1 presented the re‑ sults of a cross‑sectional study aimed to assess the prevalence of and reasons for medication‑ ‑related harm (MRH) in geriatric patients, as well as to recognize how MRH and drugs prescribed af‑ ter geriatric interventions affect patients’ survival. The analysis of 301 geriatric patients admit‑ ted to the hospital for any reason combined with a 2‑year survival analysis identified MRH in 35.2% of patients (hypotension [19.3%], hypoglycemia [13.3%], parkinsonism [4.3%], benzodiazepine ad‑ diction [5.7%], and other drug- or dosage‑related disorders). Following a geriatric intervention, 4 drug class‑ es showed a positive correlation with survival: thiazides, selective serotonin reuptake inhibi‑ tors, paracetamol, and angiotensin‑converting enzyme inhibitors. The author concluded that geriatric‑based deprescribing and drug optimi‑ zation mitigate the negative impacts of MRH on patients’ survival and may reduce the rehospital‑ ization rate and healthcare costs. The study team collected and analyzed a large amount of data, leading to an interesting and important debate. Nevertheless, we would like to make a comment focused on hypoglycemia‑ ‑related MR, which may contribute to a further and more detailed discussion of the issue. The frequency of hypoglycemic episodes was analyzed in the whole group of patients with dia‑ betes regardless of the type of diabetes and meth‑ od of treatment (ie, sulfonylureas, metformin, or insulin, as stated by the author). It is known that the frequency of hypoglycemia is higher in pa‑ tients with type 1 diabetes compared with those with type 2 diabetes treated with a similar insu‑ lin therapy.2 Still, we may presume that the ma‑ jority of patients in the study had type 2 diabetes. It also has been proven that the risk of hypogly‑ cemia is much higher in insulin‑treated patients with type 2 diabetes compared with those on oral antidiabetic drugs. For example, the United King‑ dom Prospective Diabetes Study 73 showed that patients treated with basal insulin reported hypo‑ glycemia (3.8% per year) more often than those treated with diet (0.1%), sulfonylurea (1.2%), or metformin (0.3%), but less frequently than those treated with a multiple daily insulin reg‑ imen (5.3%).3 Thus, it would be interesting to inspect hypoglycemia‑related MRH separately for insu‑ lin- and non–insulin‑treated patients and, if pos‑ sible, after excluding those with type 1 diabetes. Such an analysis could detect the real contribu‑ tion of insulin and oral antidiabetics to this MRH. With great respect, we suggest performing such an analysis or taking these comments into con‑ sideration if the continuation of this relevant study is planned.

Název v anglickém jazyce

Hypoglycemia as a medication‑related harm identified in patients admitted to geriatric wards

Popis výsledku anglicky

To the editor The article by Bień1 presented the re‑ sults of a cross‑sectional study aimed to assess the prevalence of and reasons for medication‑ ‑related harm (MRH) in geriatric patients, as well as to recognize how MRH and drugs prescribed af‑ ter geriatric interventions affect patients’ survival. The analysis of 301 geriatric patients admit‑ ted to the hospital for any reason combined with a 2‑year survival analysis identified MRH in 35.2% of patients (hypotension [19.3%], hypoglycemia [13.3%], parkinsonism [4.3%], benzodiazepine ad‑ diction [5.7%], and other drug- or dosage‑related disorders). Following a geriatric intervention, 4 drug class‑ es showed a positive correlation with survival: thiazides, selective serotonin reuptake inhibi‑ tors, paracetamol, and angiotensin‑converting enzyme inhibitors. The author concluded that geriatric‑based deprescribing and drug optimi‑ zation mitigate the negative impacts of MRH on patients’ survival and may reduce the rehospital‑ ization rate and healthcare costs. The study team collected and analyzed a large amount of data, leading to an interesting and important debate. Nevertheless, we would like to make a comment focused on hypoglycemia‑ ‑related MR, which may contribute to a further and more detailed discussion of the issue. The frequency of hypoglycemic episodes was analyzed in the whole group of patients with dia‑ betes regardless of the type of diabetes and meth‑ od of treatment (ie, sulfonylureas, metformin, or insulin, as stated by the author). It is known that the frequency of hypoglycemia is higher in pa‑ tients with type 1 diabetes compared with those with type 2 diabetes treated with a similar insu‑ lin therapy.2 Still, we may presume that the ma‑ jority of patients in the study had type 2 diabetes. It also has been proven that the risk of hypogly‑ cemia is much higher in insulin‑treated patients with type 2 diabetes compared with those on oral antidiabetic drugs. For example, the United King‑ dom Prospective Diabetes Study 73 showed that patients treated with basal insulin reported hypo‑ glycemia (3.8% per year) more often than those treated with diet (0.1%), sulfonylurea (1.2%), or metformin (0.3%), but less frequently than those treated with a multiple daily insulin reg‑ imen (5.3%).3 Thus, it would be interesting to inspect hypoglycemia‑related MRH separately for insu‑ lin- and non–insulin‑treated patients and, if pos‑ sible, after excluding those with type 1 diabetes. Such an analysis could detect the real contribu‑ tion of insulin and oral antidiabetics to this MRH. With great respect, we suggest performing such an analysis or taking these comments into con‑ sideration if the continuation of this relevant study is planned.

Druh

J_SC - Článek v periodiku v databázi SCOPUS

CEP obor

—

OECD FORD obor

30103 - Neurosciences (including psychophysiology)

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2021

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Polish Archives of Internal Medicine

ISSN

0032-3772

e-ISSN

1897-9483

Svazek periodika

131

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

PL - Polská republika

Počet stran výsledku

2

Strana od-do

313

Kód UT WoS článku

—

EID výsledku v databázi Scopus

2-s2.0-85103609620