Oral antidiabetic drugs (OAD) are commonly used in the hospital setting despite limited safety and efficacy data.

To better understand the safety and efficacy of inpatient use of OAD, we pooled data from three healthcare systems in the US and Israel between from 2008-2018 (N=78,947). Treatment with OAD in the hospital was compared to Insulin (I) and OAD+Insulin (OAD+I). Patients on OAD were slightly older than those on I or OAD+I (67 vs 64 vs 65, respectively), more likely to admitted to surgical services (OAD: 33%; I: 21%, OAD+I: 23%, p<0.0001), and to have lower admission blood glucose (Blood glucose (BG): (161 vs 200 vs 192 mg/dl, p<0.0001). The average length of stay was 4-5 days for all groups. We performed propensity score matching by age, sex, Carlson Comorbidity Index, service (medicine or surgery), admission BG and creatinine to assess glycemic control and outcomes (Table). The primary outcome was good glycemic control with defined as mean hospital BG of 80-180 mg/dL and no hypoglycemia. Compared to I, patients treated with OAD were more likely to have good glycemic control [Odds Ratio (OR): 2.07 (95% CI: 1.85, 2.31)] and less hypoglycemia defined by BG <70mg/dL [OR: 0.63 (95% CI: 0.54, 0.74)]. No differences in rate of lactic acidosis were observed.

In summary, patients treated with OAD had better in-hospital inpatient glycemic control, lower rates of hypoglycemia and no difference in lactic acidosis as compared to Insulin.


M.Fayfman: None. I.Hochberg: Other Relationship; Eli Lilly and Company, Novo Nordisk. M.F.Magee: None. A.A.Rashied: None. R.Jagannathan: None. G.Blanco: None. E.Moreno: None. F.J.Pasquel: Consultant; Dexcom, Inc., Medscape, Research Support; Dexcom, Inc., Ideal Medical Technologies. G.Umpierrez: Research Support; Abbott, Dexcom, Inc., Baxter.

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