N Z Med J. 2023 Mar 10;136(1571):30-40.
AIM: To review the management of diabetes control in patients with type 2 diabetes admitted to the cardiology service at Auckland City Hospital for over 48 hours; to assess how many would potentially benefit from introduction of empagliflozin under current Pharmac guidelines.
METHODS: A retrospective audit of all admissions into cardiology between 1 November 2020 and 31 January 2021 prior to the availability of empagliflozin. Data collected included diagnosis and presence of type 2 diabetes, HbA1c and diabetes medications.
RESULTS: A total of 449 patients were admitted, of whom 98 had type 2 diabetes. The median age was 64 years old (IQR 56-76) and 66% of patients were male. Pacific peoples were over-represented in this study population. Fifty percent had an HbA1c>60mnmol/mol and diabetes medication was changed in 50% of these. Overall, 50% of patients would be eligible for empagliflozin under current criteria.
CONCLUSIONS: High proportions of patients have poor glycaemic control and are not up-titrated, suggesting a missed opportunity for medication optimisation. Pacific peoples are over-represented in this group, suggesting that they are at high risk of diabetes and cardiovascular admissions. Empagliflozin provides a targeted way to address renal and cardiovascular outcomes.