Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper

School

Zvart Onanian School of Nursing

Department

Nursing

Date of Original Version

December 2023

Abstract

Current practice in the hospital is to hold oral antidiabetic drugs and administer insulin to prevent adverse reactions. This can lead to issues including hypoglycemic events, high glycemic variability, and poorly controlled blood glucose. Newer incretin analog drugs such as DPP-4 inhibitor do not cause hypoglycemia. A literature review was performed, and the results showed that DPP-4 inhibitors are both safe and effective in the inpatient setting with fewer hypoglycemic events, lower mean BG, and lower glycemic variability. The proposed study will compare patients with type diabetes treated with standard basal-bolus insulin therapy, against those continued on their home DPP-4 inhibitors on inpatient medical-surgical units at a single center to evaluate safety and efficacy of the different treatment modalities. A clinical support resource to better assist providers to treat type II diabetes will also be disseminated and include situations where DPP-4 inhibitor use would be contraindicated, or additional considerations such as holding a dose on the morning on surgery. The goal is for either improved or non-inferior outcomes in the treatment group in measures including mean blood glucose, hypoglycemic events, readings of poorly controlled blood glucose (>200 mg/dL) or hyperglycemic events (>350 mg/dL), and glycemic variability. Implications for APRN practice include adding to research findings supporting DPP-4 inhibitor use in the hospital, education of providers and patients, adopting the clinical decision-making tool into practice, and modifying hospital policy to reflect study findings.

Additional Files
dass_poster.pdf (629 kB)
Poster Presentation (Jennifer Fearon-Lynch, co-author)
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