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Eficacia en la reducción de eventos adversos de la insulinoterapia en pauta bolo-basal frente a la pauta deslizante en pacientes con diabetes durante la hospitalización convencional: revisión sistemática de la literatura y metaanálisis. [revisión]

Por: Gómez Cuervo, Covadonga [Medicina Interna] | Sánchez Morla, Ana [Medicina Interna] | Pérez-Jacoiste Asín, María Asunción [Medicina Interna] | Bisbal Pardo, Otilia [Medicina Interna] | Pérez Ordoño, Luis [Urgencia Hospitalaria] | Vila Santos, Juan [Medicina Interna].
Colaborador(es): Servicio de Medicina Interna | Servicio de Urgencia Hospitalaria.
Tipo de material: materialTypeLabelArtículoEditor: Endocrinología y nutrición : órgano de la Sociedad Española de Endocrinología y Nutrición. 2016Descripción: 63(4):145-56.Recursos en línea: Solicitar documento Resumen: Introduction: The aim of this review was to assess the effectiveness to reduce clinical adverse events and safety of insulin administered in basal-bolus-corrector or basal-corrector regimens (BB) versus a sliding scale scheme (SS) in patients with diabetes or newly diagnosed hyperglycemia admitted to a conventional (not critical) medical or surgical hospital ward. Method: A Medline search was conducted. The Odds ratio was the main summary measure. A random effects model with the Mantel-Haenszel procedure was used. Results: A total of 957 citations were collected, of which nine were finally included in the systematic review. Patients in the BB group had better blood glucose control than those with SS. Overall, there was a nonsignificant trend to a lower risk of adverse events in the BB as compared to the SS group (OR 0.67 [95% CI 0.22 to 2.04], [I(2)=71%]). There was a nonsignificant trend to an increased risk of hypoglycemia in the BB group (OR 2.29 [95% CI 0.50 to 10.49] [I(2)=70%]). Conclusion: Despite its benefit for glycemic control during hospitalization, this review did not show that use of the BB scheme decreases clinical events in patients hospitalized in a conventional ward. Because of heterogeneity of the results, we think that clinical trials are needed addressing its effect in patient subgroups in which the BB scheme may be used safely and with longer follow-up periods.
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Formato Vancouver:
Gómez Cuervo C, Sánchez Morla A, Pérez-Jacoiste Asín MA, Bisbal Pardo O, Pérez Ordoño L, Vila Santos J. Eficacia en la reducción de eventos adversos de la insulinoterapia en pauta bolo-basal frente a la pauta deslizante en pacientes con diabetes durante la hospitalización convencional: revisión sistemática de la literatura y metaanálisis. Endocrinol Nutr. 2016 Apr;63(4):145-56.

PMID: 26826772

Contiene 34 referencias

Introduction: The aim of this review was to assess the effectiveness to reduce clinical adverse events and safety of insulin administered in basal-bolus-corrector or basal-corrector regimens (BB) versus a sliding scale scheme (SS) in patients with diabetes or newly diagnosed hyperglycemia admitted to a conventional (not critical) medical or surgical hospital ward.
Method: A Medline search was conducted. The Odds ratio was the main summary measure. A random effects model with the Mantel-Haenszel procedure was used.
Results: A total of 957 citations were collected, of which nine were finally included in the systematic review. Patients in the BB group had better blood glucose control than those with SS. Overall, there was a nonsignificant trend to a lower risk of adverse events in the BB as compared to the SS group (OR 0.67 [95% CI 0.22 to 2.04], [I(2)=71%]). There was a nonsignificant trend to an increased risk of hypoglycemia in the BB group (OR 2.29 [95% CI 0.50 to 10.49] [I(2)=70%]).
Conclusion: Despite its benefit for glycemic control during hospitalization, this review did not show that use of the BB scheme decreases clinical events in patients hospitalized in a conventional ward. Because of heterogeneity of the results, we think that clinical trials are needed addressing its effect in patient subgroups in which the BB scheme may be used safely and with longer follow-up periods.

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