#91 Oral Diabetes Medications Inpatient: Mind the Gap Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 13 October 2021

⏱️ 24 minutes

🔗️ Recording | iTunes | RSS

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Summary

Should we use oral diabetes agents in our hospitalized patients? Do you hold metformin for fear of lactic acidosis? Do you typically order an insulin sliding scale? When can you comfortably restart PTA meds?Time Stamps:* 02:25 Can we give metformin in the hospital?* 10:50 Incretin-based therapies* 14:49 Sodium Glucose Cotransporter-2 Inhibitors* 16:27 Sulfonylurea & Thiazolidinediones* 18:00 Basal Insulin inpatientShow notes, Transcript and References: https://www.coreimpodcast.com/2021/10/13/oral-diabetes-medications-in-hospitalization-mind-the-gap-segment/ (https://www.coreimpodcast.com/2021/10/13/oral-diabetes-medications-in-hospitalization-mind-the-gap-segment/)ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im (https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im)Tags: Core IM, IM Core, glucose, insulin, hospitalized patients, oral medications, sliding scale, DPP-4, GLP-1 Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0	Hi everyone, this Coriam episode will count for
0:02.8	Sammy Credit with the American College of Physicians.
0:05.3	We'll link the exact URL in the show notes, so click on the link,
0:08.6	answer three questions, and get CME Credit.
0:11.1	And with that, let's dive into this thought-provoking topic.
0:15.0	Welcome to Mind the Gap. I'm Tyler Larson, a hospitalist at the Los Angeles VA.
0:20.0	And I'm Sethi Patel, also a hospitalist at the Los Angeles VA.
0:23.7	So today on Mind the Gap, we're talking about everyone's favorite topic.
0:27.2	Inpatient diabetes management.
0:29.2	This is Mind the Gap.
0:30.8	So we're talking about DKA, right? Not exactly the gap I wanted to focus on today,
0:35.3	except yeah. I actually wanted to talk about what the heck to do in managing type 2 diabetes in the hospital.
0:40.1	Oh, this is such a great topic. As a resident, I feel like I was taught to just hold all
0:44.8	oral diabetes meds on admission. I will tell you that if you go to Israel, 60% of patients
0:51.7	are managed with oral agents.
0:54.0	If you go to the United Kingdom,
0:56.0	about 40% are treated with oral agents,
0:59.1	and they continue to use the oral agents
1:01.3	and they are the insulin.
1:03.2	That's Dr. Guiramomperes, an endocrinologist at Emory, who has authored almost all the
1:08.0	papers on the use of diabetes meds in the hospital.
1:10.7	I'm really appreciative of his work because before we looked into it
	...

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