Visual Abstract
T1D accounts for 10% of all diabetes and DKA accounts for 8.1 per 1,000 hospitalizations. Glycemic outcomes have not been reported for adults with specifically T1D. We describe hospital glycemic outcomes for patients with T1D with and without DKA.
Individual-level data from the Glytec Inpatient Database was examined for glycemic outcomes based on pre-specified target blood glucose (BG) ranges (Table 1). All patients were treated with Glucommander IV. Data was extracted from 154 hospitals located in 17 different states in the United States (2015-2020). T1D was determined based on ICD E10.XX. The DKA group (n=4592) included patients with age > 18 years met criteria for DKA: bicarbonate <18 mmol/L, BG >250 mg/dl, and anion gap >12 mEq/L. The non DKA group (n=10,886) included patients who did not meet the DKA criteria. Prevalence of hypoglycemia and time to target (TTT) BG were stratified by target BG ranges.
In patients with DKA, % BG < 70 mg/dl and TTT was lower in the 140-180 mg/dl compared to 100-140 mg/dl target while 100-140 mg/dl had lower % BG < 40 mg/dl. In patients without DKA, BG < 70 mg/dl was lower in 140-180 mg/dl compared to 100-140 mg/dl.
This largest descriptive analysis of adult T1D patients with DKA and without DKA showed that Glucommander IV can safely get patients into prespecified target range, with minimal rates of hypoglycemia.
J. Messler: Employee; Self; Glytec, LLC. P. Vellanki: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc. B. W. Bode: Advisory Panel; Self; Eli Lilly and Company, Consultant; Self; Bigfoot Biomedical, Inc., Companion Medical, Lexicon Pharmaceuticals, Inc., Medtronic, Novo Nordisk Inc., Zealand Pharma A/S, Research Support; Self; Abvance Therapeutics, Dexcom, Inc., Diasome Pharmaceuticals, Inc., Dompe, Eli Lilly and Company, Eyenuk, Inc., Insulet Corporation, Jaeb Center for Health Research, Medtronic, Nova Biomedical, Novo Nordisk, Provention Bio, Inc., REMD Biotherapeutics, Sanofi, Senseonics, Viacyte, Inc., vTv Therapeutics, Xeris Pharmaceuticals, Inc., Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, MannKind Corporation, Medtronic, Novo Nordisk, Sanofi, Stock/Shareholder; Self; AgaMatrix, Aseko, Inc., Glytec, LLC. R. Booth: Employee; Self; Glytec, LLC. J. Clarke: Employee; Self; Aseko, Inc., Stock/Shareholder; Self; Aseko, Inc.
