Use of Diabetes Medications before and after a Heart Failure-Related Hospitalization among Nursing Home Residents.
Tingting Zhang, Andrew R Zullo, Kaleen Kaley N Hayes and 5 others
PMID 37553080WHAT IT FOUND
After heart failure hospitalization, 49.3% of nursing home residents with type 2 diabetes who used TZDs before admission and 61.9% who used SUs continued them, while GLP-1RA and SGLT-2i use was 1.0% and 0.2%.
Key findings
01Among residents who used TZDs before hospitalization, 49.3% continued them after hospitalization; among SU users, 61.9% continued, while 50.7% and 38.1% stopped respectively.
02GLP-1RA use was 1.2% before hospitalization and 1.0% after; SGLT-2i use was 0.3% before and 0.2% after.
03Use of TZDs, SUs and GLP-1RAs differed significantly between the pre- and post-hospitalization periods (p<0.001), while SGLT-2i use remained similar (p=0.17).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was descriptive and cannot show why medications changed or whether any medication change helped or harmed residents. It used claims from 2013 to 2018, so it may not reflect more recent guidelines or medication use. It lacked clinical data such as kidney function, glucose level, and hemoglobin A1C, which can affect medication choice. Medication use during skilled nursing facility stays after discharge was not observable, so some changes could be missed. It studied long-stay nursing home residents with type 2 diabetes and a heart failure hospitalization, so results may not apply to shorter stays or people without these conditions.
Declared interests
The supplied text does not include a conflicts-of-interest declaration. The article metadata lists NIH extramural research support.
The easy way to misread this
Do not read continued TZD or SU use as proof that these drugs caused harm or that stopping them improved outcomes. This was a descriptive claims study, not a trial, and it made no causal inferences.