title: Diabetes in a geriatric ward: efficacy and safety of new insulin analogs in very old inpatients.
abstract: OBJECTIVE
  1) to evaluate the prevalence of diabetes mellitus (DM) in a geriatric ward; 2) to assess the efficacy and safety of insulin analogs in elderly inpatients over 65 years of age.
  
  
  METHODS
  We analysed the medical records of 1851 elderly inpatients admitted to our geriatric clinic from March 2009 to September 2011, to identify patients with DM. The efficacy and safety of insulin analogs were measured in patients with a hospital stay of at least 9 days, by assessing the means of all glycemic sticks (4-7 sticks/day), number of hyperglycemic events (>250 mg/dL) and number of hypoglycemic events (<70 mg/dL) daily.
  
  
  RESULTS
  DM prevalence was 25% (463/1851). Diabetic patients' mean age was 82.9 ± 7.5 years. DM mortality during hospital stay was 10.8% vs 6.7% for non-diabetics (p<0.05). 206/463 diabetic inpatients were treated with insulin, and 85.9% of them received analogs (Rapid and Longer-Acting). Decreases in mean daily glycemia values (from 218.8 ± 81.6 mg/dL to 170.9 ± 42.9 mg/dL, p<0.001) and in number of hyperglycemic events (from 118 to 47) (p<0.012) were noted in 128 insulin analog-treated patients over the 9-day hospitalization. Only 35 hypoglycemic events were found out of 4745 sticks (0.7%).
  
  
  CONCLUSIONS
  1) DM prevalence and mortality in our very old inpatients are high and similar to data reported in the literature. 2) Insulin therapy with analogs is effective (achieves good glycemic control) and safe (low rate of hypoglycemia) even in these frail, very old inpatients.
authors.affiliation: Geriatric Unit, Department of Medicine, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. alessandro.franchin@unipd.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Franchin
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Corradin
authors.forename: Valter
authors.initials: V
authors.lastname: Giantin
authors.forename: Francesco
authors.initials: F
authors.lastname: Rossi
authors.forename: Federica
authors.initials: F
authors.lastname: Zanatta
authors.forename: Francesca
authors.initials: F
authors.lastname: Attanasio
authors.forename: Elena Debora
authors.initials: ED
authors.lastname: Toffanello
authors.forename: Enzo
authors.initials: E
authors.lastname: Manzato
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology* / Q000401:mortality; D006299:Health Services for the Aged; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007558:Italy / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin