Episode 364: 364. The safety and efficacy of sodium–glucose cotransporter 2 inhibitor in hospitalized patients
Questioning Medicine4 Feb 2025

Episode 364: 364. The safety and efficacy of sodium–glucose cotransporter 2 inhibitor in hospitalized patients

Gao FM et al. A systematic review and meta-analysis on the safety and efficacy of sodium–glucose cotransporter 2 inhibitor use in hospitalized patients. Diabetes Care 2024 Dec 1; 47:2275. (https://doi.org/10.2337/dc24-0946)

Trial Results

SGLT-2 inhibitors, crucial in managing diabetes, kidney disease, and heart failure, have shown promising results in hospitalized patients

1

. The meta-analysis, covering 23 randomized controlled trials with 20,000 participants, revealed:

  1. No significant increase in ketoacidosis rates (0.21 vs. 0.14 per 100 person-years)

1

  1. Lower mortality and fewer readmissions in heart failure patients

1

  1. Reduced incidence of acute kidney injury overall

1

These findings suggest that SGLT-2 inhibitors can be safely continued or initiated in hospitalized patients, particularly those with heart failure

1

.

Limitations

However, it's important to note some limitations:

  1. Potential underpowering: The study might not have had enough statistical power to detect small differences in ketoacidosis rates

1

.

  1. Risk underestimation: Including outpatient follow-up periods may have diluted the true risk of ketoacidosis during hospitalization

1

.

  1. Patient diversity: Only 30% of participants had diabetes, which might not fully represent the typical hospital population

1

.

Conclusion

While the results are encouraging, caution is still advised. The study supports current recommendations for SGLT-2 inhibitor use in hospitalized patients, especially those with heart failure, but emphasizes the need for careful monitoring and individualized decision-making

1

.This concludes our brief podcast on SGLT-2 inhibitors in hospitalized patients. Thank you for listening, and stay tuned for more updates on diabetes care and management.

Avsnitt(387)

Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Wolfe R, Broder JC, Zhou Z, et al. Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 12 Aug 2025. [Epub ahead of print]. https://...

3 Dec 202534min

Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction - https://www.nejm.org/doi/full/10.1056/NEJMoa2504735?query=WB  McGuire DK et al. Oral semaglutide and cardiovascular outcom...

17 Nov 202522min

Episode 407: 415. Do Air Filters Lower Blood Pressure?

Episode 407: 415. Do Air Filters Lower Blood Pressure?

https://pubmed.ncbi.nlm.nih.gov/40767818/This is a great example for students and residents to look and see that the abstract does not always match what the paper actually says

12 Nov 20259min

Episode 406: 414. Resistant Hypertension, Physical Therapy, Steroids for Pneumonia

Episode 406: 414. Resistant Hypertension, Physical Therapy, Steroids for Pneumonia

Efficacy and safety of Baxdrostat in uncontrolled and resistant hypertension compared to placebo in phase three when there are MRA available that are cheap and availableA randomised trial of physical ...

3 Nov 202515min

Episode 405: 413. 4 Articles to Scare You-- COPD, Cirrhosis, ETOH, and Ablation

Episode 405: 413. 4 Articles to Scare You-- COPD, Cirrhosis, ETOH, and Ablation

gabapentin may increase COPD exacerbationsBenzo for ETOH might be long gone..guess what is going to replace itAnticoagulation after ablation.... what do you do with it?BBlocker in those with cirrhosis...

31 Okt 202518min

Episode 404: 412. Liver Transplant - The One Referral I Doubt You Are Doing Correctly

Episode 404: 412. Liver Transplant - The One Referral I Doubt You Are Doing Correctly

Clinicians should refer patients for liver transplant evaluation after any decompensation event—such as ascites or variceal bleeding—regardless of MELD score. After a first decompensation, 5-year mort...

24 Okt 20257min

Episode 403: 411. Gabapentin and Emergency Carotid Artery Stenting in Stroke

Episode 403: 411. Gabapentin and Emergency Carotid Artery Stenting in Stroke

Study Summary: Emergent Carotid Stenting in Acute Stroke ThrombectomyA multicenter registry study in Catalonia (2017–2023) evaluated outcomes in 578 patients with acute ischemic stroke and tandem lesi...

22 Okt 202510min

Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

Episode 402: 410. When You Shouldn't Double Down But Instead Hit for Another

This massive meta-analysis of 484 randomized, double-blind, placebo-controlled trials (104,176 participants) quantified the blood pressure–lowering effects of major antihypertensive drug classes and t...

16 Okt 20258min

Populärt inom Hälsa

somna-med-henrik
rss-bara-en-till-om-missbruk-medberoende-2
rss-jossan-nina
inga-beiga-morsor
alska-oss
not-fanny-anymore
rss-vuxna-pa-latsas
johannes-hansen-podcast
angestpodden
rss-viktmedicinpodden
sexnoveller-deluxe
sa-in-i-sjalen
rss-psykoterapipodden
sova-med-dan-horning
brottarbroder
rss-basta-livet
rss-sjalsligt-avkladd
rss-the-house-podcast-3
rss-aldrig-lagom
dodsdomar