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PRIDE session encourages early collaboration
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NASHVILLE, Tenn. — The informal clinician–researchers group Planning Research in Inpatient Diabetes met in conjunction with the annual American Association of Clinical Endocrinologists Scientific & Clinical Congress for the first time this year to discuss ideas for research and share results of ongoing studies.
The PRIDE group was formed in 2010 by a group of academic diabetologists interested in promoting investigator-initiated research in inpatient diabetes, according to session moderator Boris Draznin, MD, PhD, director of the Adult Diabetes Program at the University of Colorado Denver School of Medicine in Aurora.
“In real life, there were too many ‘opinions’ as to how to treat hospitalized patients with diabetes and hyperglycemia but very little data from research,” Draznin told Endocrine Today. “The group meets annually to discuss their own research, planning collaborative studies, offering position statements, providing forum for open discussion of important issues in the field. The group also extended its interests to transitions of care and certain areas of outpatient management of diabetes.”
Among the presentations, Andjela T. Drincic, MD, of the University of Nebraska Medical Center in Omaha, reviewed data from her institution’s study of a diabetes resource nurse program in which nurses received extra training in inpatient diabetes care. Drincic reported a drop in overall readmission rates from 14.6% to 13.1% during the intervention.
“This is an intervention that’s easy to adopt and doesn’t cost a lot of money and can contribute to improvement of quality of care,” Drincic said.
Guillermo E. Umpierrez, MD, FACP, FACE, of Emory University School of Medicine, presented updated analysis of data from the GLUCO-CABG trial comparing intensive and conservative glucose control in patients undergoing coronary bypass surgery. He reported that intensive control did not yield a significant decrease in the rate of complications but reduced hospitalization costs and resource utilization, and that hypoglycemia rates were lower with use of a computer-guided algorithm.
Neda Rasouli, MD, associate professor of medicine at the University of Colorado Denver School of Medicine in Aurora, reviewed data from her study concluding that a glucagon-like peptide-1 receptor agonist can be a better choice than prandial insulin to add to basal insulin when treatment intensification is needed.
“That is still something that needs further studies because we don’t know that much about long-term safety of GLP-1 [receptor agonists]. Cost is still a problem,” Rasouli said. “Sometimes [a GLP-1 receptor agonist] helps in a patient with low health literacy that does not want to do the titration or … they don’t get the concept of [carbohydrate] counting or have a lot of hypoglycemia,” Rasouli said.
W. Timothy Garvey, MD, director of the diabetes research center at the University of Alabama at Birmingham, presented data to argue that a patient can have obesity and still be cardiometabolically healthy. “In cohort studies, the presence or absence of metabolic syndrome are relatively stable traits despite progressive obesity. Healthy subjects at baseline can develop one or two traits over time but rarely meet criteria for metabolic syndrome, and subjects with metabolic syndrome rarely revert to healthy status,” he said.
Nestoras N. Mathioudakis, MD, director of the inpatient diabetes management service at Johns Hopkins Medicine, reviewed his study data showing that compared with white patients with diabetes, black patients with diabetes have a greater chance of developing acute kidney injury while in the hospital, but not increased mortality or lengths of stay.
Other presentations addressed how to help fellows pursue a clinician–educator role and how best to manage glucose levels preoperatively.
“The group has published together, submitted another manuscript, found a way to conduct collaborative research projects, published one book of challenging diabetes cases, is in the process of publishing a monograph of inpatient diabetes management, and organized several working groups to address several specific issues,” Draznin told Endocrine Today.
PRIDE will continue to meet at the AACE annual meeting, according to Draznin.
Disclosure: Researchers’ relevant financial disclosures were unavailable.