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1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
2Hospital Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea
3Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Copyright © 2022 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conception or design: Y.L., J.J., Y.H.J., H.C.J. Acquisition, analysis, or interpretation of data: Y.L., J.H.O., H.S.P., H.W.K., J.L., E.S.K., N.H.K. Drafting the work or revising: Y.L., J.R., S.K., J.H.C., H.C.J. Final approval of the manuscript: Y.L., H. C.J.
Variable |
Before propensity score matching |
After propensity score matching |
||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total (n=165) | Early basal insulin group (n=86) | Delayed basal insulin group (n=79) | P value | Total (n=108) | Early basal insulin group (n=54) | Delayed basal insulin group (n=54) | P value | |||
Age, yr | 60.4±19.9 | 59.3±21.0 | 61.6±18.6 | 0.464 | 59.9±20.0 | 58.8±20.3 | 60.9±19.9 | 0.596 | ||
Female sex | 60 (36.4) | 29 (33.7) | 31 (39.2) | 0.464 | 38 (35.2) | 18 (33.3) | 20 (37) | 0.840 | ||
Height, cm | 163.9±10.4 | 165.4±10.4 | 162.2±10.2 | 0.074 | 164.3±10.0 | 164.5±10.3 | 164.0±9.7 | 0.797 | ||
Weight, kg | 63.4±19.8 | 65.7±23.0 | 60.8±15.3 | 0.326 | 63.7±19.8 | 64.0±23.3 | 63.4±15.7 | 0.886 | ||
BMI, kg/m2 | 23.5±5.3 | 24.0±5.8 | 23.0±4.6 | 0.417 | 23.6±5.3 | 23.8±5.8 | 23.5±4.8 | 0.820 | ||
Previous DM treatment | 0.451 | 0.816 | ||||||||
None | 62 (37.6) | 36 (41.9) | 26 (32.9) | 41 (38) | 21 (38.9) | 20 (37) | ||||
Insulin | 39 (23.6) | 20 (23.3) | 19 (24.1) | 22 (20.4) | 12 (22.2) | 10 (18.5) | ||||
OHA | 64 (38.8) | 30 (34.9) | 34 (43.0) | 45 (41.7) | 21 (38.9) | 24 (44.4) | ||||
Metformin | 49 (31.6) | 22 (28.2) | 27 (35.1) | 0.456 | 32 (31.4) | 13 (26.5) | 19 (35.8) | 0.424 | ||
Sulfonylurea | 36 (23.3) | 18 (23.1) | 18 (23.4) | 1.000 | 21 (20.6) | 10 (20.4) | 11 (20.8) | 1.000 | ||
DPP4 inhibitor | 49 (31.6) | 21 (26.9) | 28 (36.4) | 0.275 | 30 (29.4) | 13 (26.5) | 17 (32.1) | 0.692 | ||
SGLT2 inhibitor | 8 (5.2) | 5 (6.4) | 3 (3.9) | 0.731 | 6 (5.9) | 4 (8.2) | 2 (3.8) | 0.603 | ||
Other OHA | 9 (5.8) | 5 (6.4) | 4 (5.2) | 1.000 | 6 (5.9) | 3 (6.1) | 3 (5.7) | 1.000 | ||
Classification of DM | 0.198 | 0.875 | ||||||||
Type 1 DM | 14 (8.5) | 9 (10.5) | 5 (6.3) | 9 (8.3) | 4 (7.4) | 5 (9.3) | ||||
Type 2 DM | 138 (83.6) | 73 (84.9) | 65 (82.3) | 90 (83.3) | 46 (85.2) | 44 (81.5) | ||||
Other specific type | 13 (7.9) | 4 (4.7) | 9 (11.4) | 9 (8.3) | 4 (7.4) | 5 (9.3) | ||||
Duration of DM, yr | 8.4±9.9 | 8.6±10.1 | 8.3±9.7 | 0.872 | 8.3±9.9 | 9.5±10.5 | 7.1±9.3 | 0.231 | ||
Noncompliance | 41 (24.8) | 24 (27.9) | 17 (21.5) | 0.442 | 25 (23.1) | 16 (29.6) | 9 (16.7) | 0.171 | ||
Precipitating factor | 63 (38.2) | 30 (34.9) | 33 (41.8) | 0.454 | 40 (37) | 19 (35.2) | 21 (38.9) | 0.842 | ||
Current steroid use | 26 (15.9) | 8 (9.3) | 18 (23.1) | 0.028a | 14 (13) | 7 (13) | 7 (13) | 1.000 | ||
Classification of severe hyperglycemia | 0.151 | 0.912 | ||||||||
DKA | 41 (24.8) | 20 (23.3) | 21 (26.6) | 33 (30.6) | 17 (31.5) | 16 (29.6) | ||||
HHS | 32 (19.4) | 17 (19.8) | 15 (19.0) | 22 (20.4) | 11 (20.4) | 11 (20.4) | ||||
HHS with ketoacidosis | 50 (30.3) | 32 (37.2) | 18 (22.8) | 28 (25.9) | 15 (27.8) | 13 (24.1) | ||||
Non-DKA or HHS | 42 (25.5) | 17 (19.8) | 25 (31.6) | 25 (23.1) | 11 (20.4) | 14 (25.9) | ||||
Admission to ICU | 17 (10.3) | 8 (9.3) | 9 (11.4) | 0.853 | 9 (8.3) | 4 (7.4) | 5 (9.3) | 1.000 | ||
Initial laboratory values | ||||||||||
pH | 7.28±0.16 | 7.27±0.16 | 7.30±0.15 | 0.263 | 7.28±0.15 | 7.27±0.15 | 7.29±0.16 | 0.415 | ||
Bicarbonate, mmol/L | 17.9±8.5 | 17.1±8.4 | 18.7±8.6 | 0.255 | 17.93±8.89 | 17.2±8.6 | 18.7±9.22 | 0.407 | ||
Glucose, mg/dL | 630.3±276.9 | 660.2±275.0 | 597.8±276.9 | 0.149 | 641.8±290.0 | 658.8±292.7 | 624.9±289.1 | 0.546 | ||
BUN, mg/dL | 40.5±28.3 | 39.7±27.6 | 41.3±29.3 | 0.723 | 37.8±24.2 | 39.9±28.4 | 35.6±19.2 | 0.363 | ||
Creatinine, mg/dL | 2.1±1.6 | 1.9±1.1 | 2.2±1.9 | 0.223 | 2.0±1.3 | 2.1±1.3 | 1.9±1.3 | 0.434 | ||
HbA1c, % | 11.0±2.7 | 11.3±2.5 | 10.6±2.9 | 0.091 | 10.9±2.8 | 11.1±2.3 | 10.8±3.2 | 0.543 | ||
HbA1c, mmol/mol | 96.6±29.6 | 100.3±27.2 | 92.4±31.8 | 0.070 | 96±30.2 | 97.8±25.1 | 94.2±34.8 | 0.435 | ||
C-peptide, ng/mL | 2.2±2.6 | 2.1±2.9 | 2.3±2.3 | 0.586 | 2.2±2.7 | 2.1±2.9 | 2.2±2.5 | 0.890 | ||
β-Hydroxybutyrate, mmol/L | 1.5±1.6 | 1.7±1.8 | 1.3±1.4 | 0.247 | 1.4±1.6 | 1.5±1.8 | 1.4±1.4 | 0.856 | ||
Osmolality, mOsm/kg | 331.6±64.4 | 337.2±36.7 | 325.3±30.8 | 0.034a | 328.5±34.9 | 333.2±38.7 | 324.2±30.7 | 0.204 |
Values are expressed as mean±standard deviation or number (%).
BMI, body mass index; DM, diabetes mellitus; OHA, oral hypoglycemic agent; DPP4, dipeptidyl peptidase 4; SGLT2, sodium/glucose cotransporter 2; DKA, diabetic ketoacidosis; HHS, hyperosmolar hyperglycemic state; ICU, intensive care unit; BUN, blood urea nitrogen; HbA1c, glycated hemoglobin.
a Values are statistically significant (P<0.05) by Fisher’s exact test or Mann-Whitney U test for categorical or continuous variables, respectively.
Variable |
Before propensity score matching |
After propensity score matching |
||||
---|---|---|---|---|---|---|
Early basal insulin group (n=86) | Delayed basal insulin group (n=79) | P value | Early basal insulin group (n=86) | Delayed basal insulin group (n=79) | P value | |
Administration interval between CIII initiation and the first basal insulin, hr | 2.0±5.5 | 29.4±24.1 | <0.001a | 1.4±5.0 | 28.4±26.1 | <0.001a |
Duration of CIII, hr | 36.4±29.7 | 30.3±24.3 | 0.136 | 35.3±31.0 | 29.9±26.6 | 0.270 |
Glucose level immediately before CIII discontinuation, mg/dL | 177.1±40.9 | 168.9±45.9 | 0.296 | 175.2±39.6 | 168.2±44.0 | 0.391 |
First dose of subcutaneous basal insulin, U | 16.6±5.6 | 16.7±8.1 | 0.660 | 16.4±5.7 | 18.6±8.9 | 0.137 |
No. of blood glucose sampleb | 4.7±1.1 | 4.8±1.4 | 0.977 | 4.7±1.0 | 4.8±1.3 | 0.584 |
Hypoglycemiac | 5 (5.8) | 4 (5.1) | 1.000 | 3 (5.6) | 2 (3.7) | 1.000 |
Variable |
Before propensity score matching |
After propensity score matching |
||
---|---|---|---|---|
Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | |
Univariable | ||||
Groupa | 0.20 (0.09–0.42) | <0.001b | 0.19 (0.07–0.47) | <0.001b |
Multivariable | ||||
Groupa | 0.16 (0.06–0.43) | <0.001b | 0.14 (0.04–0.47) | 0.001b |
Age | 0.99 (0.96–1.02) | 0.499 | 0.99 (0.95–1.03) | 0.480 |
Body mass index, kg/m2 | 1.10 (0.98–1.26) | 0.146 | 1.14 (0.96–1.35) | 0.132 |
Classification (DKA) | 0.72 (0.17– 2.99) | 0.648 | 0.38 (0.06–2.45) | 0.306 |
Classification (HHS) | 0.97 (0.24–3.89) | 0.969 | 0.95 (0.16–5.73) | 0.952 |
Classification (DKA with ketoacidosis) | 0.53 (0.15–1.94) | 0.339 | 0.55 (0.10–3.18) | 0.507 |
Dose of basal insulin, U | 1.10 (0.97–1.25) | 0.155 | 1.09 (0.95–1.27) | 0.223 |
Duration of CIII, hr | 0.98 (0.96–1.00) | 0.064 | 0.98 (0.96–1.00) | 0.081 |
Glucose level immediately before CIII discontinuation, mg/dL | 1.02 (1.01–1.03) | 0.005b | 1.02 (1.00–1.03) | 0.049b |
Duration of DM, yr | 1.00 (0.95–1.06) | 0.876 | 1.00 (0.93–1.08) | 0.942 |
Precipitating factor | 2.30 (0.80–6.57) | 0.120 | 2.10 (0.58–7.58) | 0.258 |
OHA (metformin) | 1.15 (0.34–3.93) | 0.181 | 2.32 (0.47–11.48) | 0.304 |
OHA (sulfonylurea) | 1.13 (0.34–3.71) | 0.842 | 0.59 (0.12–2.85) | 0.512 |
OHA (DPP4 inhibitor) | 0.46 (0.13–1.65) | 0.231 | 0.29 (0.05–1.57) | 0.151 |
OHA (SGLT2 inhibitor) | 0.89 (0.13–5.98) | 0.906 | 2.56 (0.26–25.6) | 0.425 |
CI, confidence interval; DKA, diabetic ketoacidosis; HHS, hyperosmolar hyperglycemic state; CIII, continuous intravenous insulin infusion; DM, diabetes mellitus; OHA, oral hypoglycemic agent; DPP4, dipeptidyl peptidase 4; SGLT2, sodium/glucose cotransporter 2.
a Early vs. delayed basal insulin group;
b Values are statistically significant (P<0.05) by logistic regression analyses.
Variable |
Difference in glucose levels before PSM (n=165) |
Difference in glucose levels after PSM (n=108) |
Length of hospital stay (n=144) |
||||
---|---|---|---|---|---|---|---|
Β±SE | P value | Β±SE | P value | Β±SE | P value | ||
Univariable | |||||||
Groupa | –79.92±15.34 | <0.001b | –84.83±18.76 | <0.001b | –1.13±0.56 | 0.046b | |
Multivariable | |||||||
Groupa | –84.61±22.88 | <0.001b | –84.59±25.76 | 0.001b | –1.20±0.53 | 0.027b | |
Age, yr | –0.29±0.49 | 0.562 | –0.86±0.62 | 0.169 | –0.00±0.02 | 0.837 | |
BMI, kg/m2 | 3.19±2.02 | 0.117 | 1.54±2.37 | 0.519 | - | - | |
Classification (DKA)c | –27.80±22.91 | 0.227 | –35.76±27.97 | 0.204 | 0.52±0.78 | 0.505 | |
Classification (HHS)c | –27.09±23.40 | 0.249 | –33.38±28.48 | 0.244 | 1.64±0.81 | 0.043b | |
Classification (HHS with ketoacidosis)c | –14.423±22.26 | 0.518 | –21.64±27.85 | 0.439 | 0.38±0.75 | 0.613 | |
Dose of basal insulin, U | –0.66±1.53 | 0.669 | 0.38±1.71 | 0.825 | - | - | |
Duration of CIII, hr | –0.27±0.41 | 0.511 | –0.42±0.44 | 0.353 | 0.02±0.01 | 0.056 | |
Glucose level immediately before CIII discontinuation, mg/dL | –0.90±0.19 | <0.001b | –0.96±0.23 | <0.001b | - | - | |
Duration of DM, yr | 0.63±0.86 | 0.467 | 1.85±1.07 | 0.085 | –0.03±0.03 | 0.390 | |
Precipitating factor | –27.92±17.33 | 0.109 | –22.10±20.55 | 0.285 | 2.11±0.63 | 0.001b | |
OHA (metformin) | 3.79±22.97 | 0.869 | –0.95±27.07 | 0.972 | - | - | |
OHA (sulfonylurea) | 9.41±23.13 | 0.685 | 14.73±28.66 | 0.609 | - | - | |
OHA (DPP4 inhibitor) | –1.55±23.70 | 0.948 | –24.65±28.47 | 0.389 | - | - | |
OHA (SGLT2 inhibitor) | 3.71±40.16 | 0.927 | 21.15±45.66 | 0.645 | - | - |
B, β coefficient; SE, standard error; PSM, propensity score matching; BMI, body mass index; DKA, diabetic ketoacidosis; HHS, hyperosmolar hyperglycemic state; CIII, continuous intravenous insulin infusion; DM, diabetes mellitus; OHA, oral hypoglycemic agent; DPP4, dipeptidyl peptidase 4; SGLT2, sodium/glucose cotransporter 2.
a Early vs. delayed basal insulin group;
b Values are statistically significant (P<0.05) by linear regression analyses;
c Data are compared to the category of severe hyperglycemia that did not satisfy the criteria for either DKA or HHS.
Variable | Before propensity score matching |
After propensity score matching |
||||||||
---|---|---|---|---|---|---|---|---|---|---|
Total (n=165) | Early basal insulin group (n=86) | Delayed basal insulin group (n=79) | P value | Total (n=108) | Early basal insulin group (n=54) | Delayed basal insulin group (n=54) | P value | |||
Age, yr | 60.4±19.9 | 59.3±21.0 | 61.6±18.6 | 0.464 | 59.9±20.0 | 58.8±20.3 | 60.9±19.9 | 0.596 | ||
Female sex | 60 (36.4) | 29 (33.7) | 31 (39.2) | 0.464 | 38 (35.2) | 18 (33.3) | 20 (37) | 0.840 | ||
Height, cm | 163.9±10.4 | 165.4±10.4 | 162.2±10.2 | 0.074 | 164.3±10.0 | 164.5±10.3 | 164.0±9.7 | 0.797 | ||
Weight, kg | 63.4±19.8 | 65.7±23.0 | 60.8±15.3 | 0.326 | 63.7±19.8 | 64.0±23.3 | 63.4±15.7 | 0.886 | ||
BMI, kg/m2 | 23.5±5.3 | 24.0±5.8 | 23.0±4.6 | 0.417 | 23.6±5.3 | 23.8±5.8 | 23.5±4.8 | 0.820 | ||
Previous DM treatment | 0.451 | 0.816 | ||||||||
None | 62 (37.6) | 36 (41.9) | 26 (32.9) | 41 (38) | 21 (38.9) | 20 (37) | ||||
Insulin | 39 (23.6) | 20 (23.3) | 19 (24.1) | 22 (20.4) | 12 (22.2) | 10 (18.5) | ||||
OHA | 64 (38.8) | 30 (34.9) | 34 (43.0) | 45 (41.7) | 21 (38.9) | 24 (44.4) | ||||
Metformin | 49 (31.6) | 22 (28.2) | 27 (35.1) | 0.456 | 32 (31.4) | 13 (26.5) | 19 (35.8) | 0.424 | ||
Sulfonylurea | 36 (23.3) | 18 (23.1) | 18 (23.4) | 1.000 | 21 (20.6) | 10 (20.4) | 11 (20.8) | 1.000 | ||
DPP4 inhibitor | 49 (31.6) | 21 (26.9) | 28 (36.4) | 0.275 | 30 (29.4) | 13 (26.5) | 17 (32.1) | 0.692 | ||
SGLT2 inhibitor | 8 (5.2) | 5 (6.4) | 3 (3.9) | 0.731 | 6 (5.9) | 4 (8.2) | 2 (3.8) | 0.603 | ||
Other OHA | 9 (5.8) | 5 (6.4) | 4 (5.2) | 1.000 | 6 (5.9) | 3 (6.1) | 3 (5.7) | 1.000 | ||
Classification of DM | 0.198 | 0.875 | ||||||||
Type 1 DM | 14 (8.5) | 9 (10.5) | 5 (6.3) | 9 (8.3) | 4 (7.4) | 5 (9.3) | ||||
Type 2 DM | 138 (83.6) | 73 (84.9) | 65 (82.3) | 90 (83.3) | 46 (85.2) | 44 (81.5) | ||||
Other specific type | 13 (7.9) | 4 (4.7) | 9 (11.4) | 9 (8.3) | 4 (7.4) | 5 (9.3) | ||||
Duration of DM, yr | 8.4±9.9 | 8.6±10.1 | 8.3±9.7 | 0.872 | 8.3±9.9 | 9.5±10.5 | 7.1±9.3 | 0.231 | ||
Noncompliance | 41 (24.8) | 24 (27.9) | 17 (21.5) | 0.442 | 25 (23.1) | 16 (29.6) | 9 (16.7) | 0.171 | ||
Precipitating factor | 63 (38.2) | 30 (34.9) | 33 (41.8) | 0.454 | 40 (37) | 19 (35.2) | 21 (38.9) | 0.842 | ||
Current steroid use | 26 (15.9) | 8 (9.3) | 18 (23.1) | 0.028 |
14 (13) | 7 (13) | 7 (13) | 1.000 | ||
Classification of severe hyperglycemia | 0.151 | 0.912 | ||||||||
DKA | 41 (24.8) | 20 (23.3) | 21 (26.6) | 33 (30.6) | 17 (31.5) | 16 (29.6) | ||||
HHS | 32 (19.4) | 17 (19.8) | 15 (19.0) | 22 (20.4) | 11 (20.4) | 11 (20.4) | ||||
HHS with ketoacidosis | 50 (30.3) | 32 (37.2) | 18 (22.8) | 28 (25.9) | 15 (27.8) | 13 (24.1) | ||||
Non-DKA or HHS | 42 (25.5) | 17 (19.8) | 25 (31.6) | 25 (23.1) | 11 (20.4) | 14 (25.9) | ||||
Admission to ICU | 17 (10.3) | 8 (9.3) | 9 (11.4) | 0.853 | 9 (8.3) | 4 (7.4) | 5 (9.3) | 1.000 | ||
Initial laboratory values | ||||||||||
pH | 7.28±0.16 | 7.27±0.16 | 7.30±0.15 | 0.263 | 7.28±0.15 | 7.27±0.15 | 7.29±0.16 | 0.415 | ||
Bicarbonate, mmol/L | 17.9±8.5 | 17.1±8.4 | 18.7±8.6 | 0.255 | 17.93±8.89 | 17.2±8.6 | 18.7±9.22 | 0.407 | ||
Glucose, mg/dL | 630.3±276.9 | 660.2±275.0 | 597.8±276.9 | 0.149 | 641.8±290.0 | 658.8±292.7 | 624.9±289.1 | 0.546 | ||
BUN, mg/dL | 40.5±28.3 | 39.7±27.6 | 41.3±29.3 | 0.723 | 37.8±24.2 | 39.9±28.4 | 35.6±19.2 | 0.363 | ||
Creatinine, mg/dL | 2.1±1.6 | 1.9±1.1 | 2.2±1.9 | 0.223 | 2.0±1.3 | 2.1±1.3 | 1.9±1.3 | 0.434 | ||
HbA1c, % | 11.0±2.7 | 11.3±2.5 | 10.6±2.9 | 0.091 | 10.9±2.8 | 11.1±2.3 | 10.8±3.2 | 0.543 | ||
HbA1c, mmol/mol | 96.6±29.6 | 100.3±27.2 | 92.4±31.8 | 0.070 | 96±30.2 | 97.8±25.1 | 94.2±34.8 | 0.435 | ||
C-peptide, ng/mL | 2.2±2.6 | 2.1±2.9 | 2.3±2.3 | 0.586 | 2.2±2.7 | 2.1±2.9 | 2.2±2.5 | 0.890 | ||
β-Hydroxybutyrate, mmol/L | 1.5±1.6 | 1.7±1.8 | 1.3±1.4 | 0.247 | 1.4±1.6 | 1.5±1.8 | 1.4±1.4 | 0.856 | ||
Osmolality, mOsm/kg | 331.6±64.4 | 337.2±36.7 | 325.3±30.8 | 0.034 |
328.5±34.9 | 333.2±38.7 | 324.2±30.7 | 0.204 |
Variable | Before propensity score matching |
After propensity score matching |
||||
---|---|---|---|---|---|---|
Early basal insulin group (n=86) | Delayed basal insulin group (n=79) | P value | Early basal insulin group (n=86) | Delayed basal insulin group (n=79) | P value | |
Administration interval between CIII initiation and the first basal insulin, hr | 2.0±5.5 | 29.4±24.1 | <0.001 |
1.4±5.0 | 28.4±26.1 | <0.001 |
Duration of CIII, hr | 36.4±29.7 | 30.3±24.3 | 0.136 | 35.3±31.0 | 29.9±26.6 | 0.270 |
Glucose level immediately before CIII discontinuation, mg/dL | 177.1±40.9 | 168.9±45.9 | 0.296 | 175.2±39.6 | 168.2±44.0 | 0.391 |
First dose of subcutaneous basal insulin, U | 16.6±5.6 | 16.7±8.1 | 0.660 | 16.4±5.7 | 18.6±8.9 | 0.137 |
No. of blood glucose sample |
4.7±1.1 | 4.8±1.4 | 0.977 | 4.7±1.0 | 4.8±1.3 | 0.584 |
Hypoglycemia |
5 (5.8) | 4 (5.1) | 1.000 | 3 (5.6) | 2 (3.7) | 1.000 |
Variable | Before propensity score matching |
After propensity score matching |
||
---|---|---|---|---|
Odds ratio (95% CI) | P value | Odds ratio (95% CI) | P value | |
Univariable | ||||
Group |
0.20 (0.09–0.42) | <0.001 |
0.19 (0.07–0.47) | <0.001 |
Multivariable | ||||
Group |
0.16 (0.06–0.43) | <0.001 |
0.14 (0.04–0.47) | 0.001 |
Age | 0.99 (0.96–1.02) | 0.499 | 0.99 (0.95–1.03) | 0.480 |
Body mass index, kg/m2 | 1.10 (0.98–1.26) | 0.146 | 1.14 (0.96–1.35) | 0.132 |
Classification (DKA) | 0.72 (0.17– 2.99) | 0.648 | 0.38 (0.06–2.45) | 0.306 |
Classification (HHS) | 0.97 (0.24–3.89) | 0.969 | 0.95 (0.16–5.73) | 0.952 |
Classification (DKA with ketoacidosis) | 0.53 (0.15–1.94) | 0.339 | 0.55 (0.10–3.18) | 0.507 |
Dose of basal insulin, U | 1.10 (0.97–1.25) | 0.155 | 1.09 (0.95–1.27) | 0.223 |
Duration of CIII, hr | 0.98 (0.96–1.00) | 0.064 | 0.98 (0.96–1.00) | 0.081 |
Glucose level immediately before CIII discontinuation, mg/dL | 1.02 (1.01–1.03) | 0.005 |
1.02 (1.00–1.03) | 0.049 |
Duration of DM, yr | 1.00 (0.95–1.06) | 0.876 | 1.00 (0.93–1.08) | 0.942 |
Precipitating factor | 2.30 (0.80–6.57) | 0.120 | 2.10 (0.58–7.58) | 0.258 |
OHA (metformin) | 1.15 (0.34–3.93) | 0.181 | 2.32 (0.47–11.48) | 0.304 |
OHA (sulfonylurea) | 1.13 (0.34–3.71) | 0.842 | 0.59 (0.12–2.85) | 0.512 |
OHA (DPP4 inhibitor) | 0.46 (0.13–1.65) | 0.231 | 0.29 (0.05–1.57) | 0.151 |
OHA (SGLT2 inhibitor) | 0.89 (0.13–5.98) | 0.906 | 2.56 (0.26–25.6) | 0.425 |
Variable | Difference in glucose levels before PSM (n=165) |
Difference in glucose levels after PSM (n=108) |
Length of hospital stay (n=144) |
||||
---|---|---|---|---|---|---|---|
Β±SE | P value | Β±SE | P value | Β±SE | P value | ||
Univariable | |||||||
Group |
–79.92±15.34 | <0.001 |
–84.83±18.76 | <0.001 |
–1.13±0.56 | 0.046 |
|
Multivariable | |||||||
Group |
–84.61±22.88 | <0.001 |
–84.59±25.76 | 0.001 |
–1.20±0.53 | 0.027 |
|
Age, yr | –0.29±0.49 | 0.562 | –0.86±0.62 | 0.169 | –0.00±0.02 | 0.837 | |
BMI, kg/m2 | 3.19±2.02 | 0.117 | 1.54±2.37 | 0.519 | - | - | |
Classification (DKA) |
–27.80±22.91 | 0.227 | –35.76±27.97 | 0.204 | 0.52±0.78 | 0.505 | |
Classification (HHS) |
–27.09±23.40 | 0.249 | –33.38±28.48 | 0.244 | 1.64±0.81 | 0.043 |
|
Classification (HHS with ketoacidosis)c | –14.423±22.26 | 0.518 | –21.64±27.85 | 0.439 | 0.38±0.75 | 0.613 | |
Dose of basal insulin, U | –0.66±1.53 | 0.669 | 0.38±1.71 | 0.825 | - | - | |
Duration of CIII, hr | –0.27±0.41 | 0.511 | –0.42±0.44 | 0.353 | 0.02±0.01 | 0.056 | |
Glucose level immediately before CIII discontinuation, mg/dL | –0.90±0.19 | <0.001 |
–0.96±0.23 | <0.001 |
- | - | |
Duration of DM, yr | 0.63±0.86 | 0.467 | 1.85±1.07 | 0.085 | –0.03±0.03 | 0.390 | |
Precipitating factor | –27.92±17.33 | 0.109 | –22.10±20.55 | 0.285 | 2.11±0.63 | 0.001 |
|
OHA (metformin) | 3.79±22.97 | 0.869 | –0.95±27.07 | 0.972 | - | - | |
OHA (sulfonylurea) | 9.41±23.13 | 0.685 | 14.73±28.66 | 0.609 | - | - | |
OHA (DPP4 inhibitor) | –1.55±23.70 | 0.948 | –24.65±28.47 | 0.389 | - | - | |
OHA (SGLT2 inhibitor) | 3.71±40.16 | 0.927 | 21.15±45.66 | 0.645 | - | - |
Values are expressed as mean±standard deviation or number (%). BMI, body mass index; DM, diabetes mellitus; OHA, oral hypoglycemic agent; DPP4, dipeptidyl peptidase 4; SGLT2, sodium/glucose cotransporter 2; DKA, diabetic ketoacidosis; HHS, hyperosmolar hyperglycemic state; ICU, intensive care unit; BUN, blood urea nitrogen; HbA1c, glycated hemoglobin. Values are statistically significant (
Values are expressed as mean±standard deviation or number (%). CIII, continuous intravenous insulin infusion. Values are statistically significant ( During 24 hours after CIII discontinuation;
CI, confidence interval; DKA, diabetic ketoacidosis; HHS, hyperosmolar hyperglycemic state; CIII, continuous intravenous insulin infusion; DM, diabetes mellitus; OHA, oral hypoglycemic agent; DPP4, dipeptidyl peptidase 4; SGLT2, sodium/glucose cotransporter 2. Early vs. delayed basal insulin group; Values are statistically significant (
B, β coefficient; SE, standard error; PSM, propensity score matching; BMI, body mass index; DKA, diabetic ketoacidosis; HHS, hyperosmolar hyperglycemic state; CIII, continuous intravenous insulin infusion; DM, diabetes mellitus; OHA, oral hypoglycemic agent; DPP4, dipeptidyl peptidase 4; SGLT2, sodium/glucose cotransporter 2. Early vs. delayed basal insulin group; Values are statistically significant ( Data are compared to the category of severe hyperglycemia that did not satisfy the criteria for either DKA or HHS.