• Eur. J. Intern. Med. · Mar 2024

    Glycemic control and prescription profiles in internal medicine inpatients: The role of frailty.

    • Jose Carlos Arévalo Lorido, Juana Carretero Gomez, Patricia Vazquez Rodriguez, Ricardo Gómez Huelgas, Carmen Marín Silvente, Fernando Javier Sánchez Lora, Elena Isaba Ares, Anna Pardo I Pelegrín, Onán Pérez Hernández, and Javier Ena.
    • Internal Medicine Service, Hospital Universitario de Badajoz, Avda de Elvas, s/n, Badajoz 06080, Spain.
    • Eur. J. Intern. Med. 2024 Mar 1; 121: 103108103-108.

    AimThis work aims to characterize the clinical profile of individuals with frailty syndrome, diabetes mellitus (DM), and hyperglycemia during hospitalization in regard to glycemic control and treatment regimen.MethodsThis cross-sectional multicentric study included patients with DM or hyperglycemia at admission. Demographic data, blood glucose values, treatment administered during hospitalization, and treatment indicated at discharge were analyzed. The sample was divided into three groups according to score on a frailty questionnaire. Generalized additive models were used to describe the relationship between either glycemic variability (GV) or minimum capillary blood glucose and hypoglycemia. Models were adjusted for age, comorbidity, and sarcopenia.ResultsA total of 1,137 patients were analyzed. Patients with frailty syndrome had more comorbidity and sarcopenia, worse renal function, and lower albumin and lymphocyte levels. A GV between 21% and 60% was related to a higher probability of hypoglycemia, especially in patients with frailty. Regarding minimum capillary blood glucose, patients with frailty had the highest probability of hypoglycemia. This probability remained significant even in the group with frailty in which, with a reference value of 200 mg/dl, the adjusted odds ratio of a minimum capillary blood glucose of 151 mg/dL was 1.08 (95% confidence interval (1.12-1.05)). Baseline treatments showed a significant predominance of insulin use in the frailest groups.ConclusionsPatients with frailty had more sarcopenia and undernourishment. These patients were managed in a similar manner during hospitalization to patients without frailty, despite their higher risk of hypoglycemia according to GV or minimum capillary blood glucose levels.Copyright © 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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