Compliance with Prescription Guidelines for Glucose-Lowering Therapies According to Renal Function: Real-Life Study in Inpatients of Internal Medicine, Endocrinology and Cardiology Units

Laura Lohan (1, 2) , Florence Galtier (3, 2, 4) , Thibault Manson (3, 2) , Thibault Mura (3, 2, 5) , Audrey Castet-Nicolas (3, 2, 6) , Delinger Faure (3, 2) , Nicolas Chapet (3, 2) , Florence Leclercq (3, 2) , Jean Luc Pasquié (1, 2) , François Roubille (1, 2) , Camille Roubille (1, 2) , Hubert Blain (3, 2, 7) , Philippe Guilpain (3, 2, 8) , Maxime Villiet (3, 2) , Antoine Avignon (3, 2, 1) , Ariane Sultan (1, 2) , Cyril Breuker (1, 2)

1 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
2 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
3 UM - Université de Montpellier
4 BC2M - Biocommunication en Cardio-Métabolique
5 INM - Institut des Neurosciences de Montpellier
6 IRCM - U1194 Inserm - UM - Institut de Recherche en Cancérologie de Montpellier
7 Euromov DHM - EuroMov - Digital Health in Motion
8 Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB)

Background and objectives: Renal failure is a contraindication for some glucose-lowering drugs and requires dosage adjustment for others, particularly biguanides, sulfonylureas, and inhibitors of dipeptidyl peptidase 4. In this study, we assessed adherence to prescription recommendations for glucose-lowering drugs according to renal function in hospitalized diabetic subjects.Materials and Methods: This prospective cohort study was carried out over a 2-year period in a university hospital. Glomerular filtration rate (GFR) was determined by averaging all measurements performed during hospitalization. Glucose-lowering drug dosages were analyzed according to the recommendations of the relevant medical societies.Results: In total, 2071 diabetic patients (53% hospitalized in cardiology units) were examined. GFR was <30 mL/min/1.73 m2 in 13.4% of these patients, 30–44 in 15.1%, 45–60 in 18.3%, and >60 in 53.3%. Inappropriate oral glucose-lowering treatments were administered to 273 (13.2%) patients, including 53 (2.6%) with a contraindication. In cardiology units, 53.1% and 14.3% of patients had GFRs of <60 and <30 mL/min/1.73 m2, respectively, and 179 (15.4%) patients had a contraindication or were prescribed an excessive dose of glucose-lowering drugs.Conclusions: We showed that the burden of inappropriate prescriptions is high in diabetic patients. Given the high number of patients receiving these medications, particularly in cardiology units, a search for potential adverse effects related to these drugs should be performed.

Mots clés: Glucose-lowering drugs; Cardiovascular medicine; Renal function; Diabetes mellitus; Prescription guidelines

Domaines: Endocrinologie et métabolisme; Urologie et Néphrologie; Pharmacologie

Laura Lohan, Florence Galtier, Thibault Manson, Thibault Mura, Audrey Castet-Nicolas, et al.. Compliance with Prescription Guidelines for Glucose-Lowering Therapies According to Renal Function: Real-Life Study in Inpatients of Internal Medicine, Endocrinology and Cardiology Units. Medicina, 2021, 57 (12), pp.1376. ⟨10.3390/medicina57121376⟩. ⟨hal-03498738v2⟩