Amélioration de la prise en charge de la hyperglycémie chez les patients diabétiques pendant l'hospitalisation et évaluation de la sécurité des médicaments antidiabétiques

 

Oriana Hoi Yun Yu

CIUSSS du Centre-Ouest-de-l'Île-de-Montréal

 

Domaine : santé des populations

Programme Chercheurs-boursiers cliniciens - Junior 1

Concours 2018-2019

My research program focuses on how we can improve diabetes treatment. One arm of my program involves conducting a study that aims to determine the glucose target associated with decreased complications during hospitalization. Currently, diabetes guidelines recommend having a pre-meal glucose between 5 and 8mmol/L and no glucose more than 10mmol/L during hospitalization. However, it is challenging to achieve these targets and there is no evidence to suggest that this range improves patient outcomes during hospitalization. In fact, having a lower glucose may increase the risk of hypoglycemia. This study will be conducted in three university-affiliated hospitals where we will determine whether lower glucose levels (i.e. 4 to 7mmol/L) compared to higher glucose levels (7.1 to 10mmol/L) during hospitalization in a non-critical care setting is associated with decreased risk of complications. This study will involve data collection for hospitalized patients with diabetes, which will provide data for studies in the future related to management of diabetes in an inpatient setting.

The second arm of my research program involves studies assessing drug safety of antidiabetic medications. Recently, sodium-glucose co-transporter (SGLT) 2 inhibitors have been made available for managing type 2 diabetes. SGLT2 inhibitors cause glucose to be excreted in the urine, which decreases glucose levels. Clinical trials performed so far show that SGLT2 inhibitors may also reduce heart disease. However, one study showed an increased risk of amputations among patients treated with SGLT2 inhibitors (i.e. canagliflozin). The cause of amputations is not known. Given that approximately 40% of amputations are caused by peripheral vascular disease (PVD) among patients with type 2 diabetes, I plan to conduct a study to determine whether patients treated with SGLT2 inhibitors are associated with an increased risk of PVD.  Using similar methods, we will also conduct drug safety studies associated with the use of SGLT2 inhibitors.