Updates on the Management of Hyperglycemia in Hospitalized Adult Patients

Round 1

Reviewer 1 Report

The manuscript is a review describing management of hyperglycemia in hospitalized adult patients. The topic of the manuscript is very interesting and important in everyday clinical practice. As the authors already stated in the manuscript, the data from randomized controlled trials are at some points very scarce. The manuscript is well written, I suggest English editing before the publication. Additionally, I suggest using both values for different units of glucose levels (mg/dL and also mmol/L).

 

English editing is suggested before the publication.

Author Response

Thank you for reviewing our manuscript, we have added the different system units values and additional English editing is  added. 

Author Response File: Author Response.docx

Reviewer 2 Report

The aim of the review is "Updates In Management of Hyperglycemia in Hospitalized Adult Patients"

First, I would like to point out the misunderstanding of the term "keywords", which are incorrectly understood as phrases in this context.

The introduction lacks a definition of the aim, which could be deduced based on the title of the article. Although some recommendations are summarized in tabular form, even in the conclusion it is not clear whether the authors wanted to focus on intensive care unit patients, diabetics, or in general on hyperglycemic patients without confirming the diagnosis of diabetes - and not even the type of diabetes.

Additional notes: the text is difficult to understand, it contains many unexplained abbreviations (ICU, pts, am, A1c instead HbA1c....., colloquial expressions eg. post-op, "Hypoglycemia in the hospital" instead "in hospitalized patients", Glycemic Targets and Management of Hyperglycemia "in?" ICU Patients, practice changing trials...), incorrect use of punctuation eg. lines 30-36-40-42-46... (the period before the reference); line 389: "In Summary; glycemic..."

Chapters 2 and 3 describe the impact of hyper- and hypoglycemia in general, regardless of whether they were diabetic patients or whether they were hospitalized due to complications associated with diabetes.

In the summary the authors state "In this review, we evaluated historical and most recent studies regarding increased risk of adverse outcome in hospitalized patients with diabetes and hyperglycemia" - as most of it was discussed in chapters 4 to 11, but not with emphasis on diabetes, and if, without indicating the type of diabetes, or in women, whether it was preeclampsia, etc.

Author Response

Thank you for reviewing our manuscript and thank you for your constructive suggestions. We have corrected the Key words. We have corrected references after each sentences. We have clarified in the summary that  we review the data for both hospitalized patients with diabetes and hospitalized patients without diabetes presented with stress hyperglycemia.  We added clarification that treatment of type 1 diabetes  stays the same in hospitalized patients with basal and meal dose insulin.   

We reviewed the data on adverse outcome of hyperglycemia and hypoglycemia in hospitalized patients with or without history of diabetes. As stress hyperglycemia can occur without previous history of diabetes and hypoglycemia can be seen in hospitalized patients due to nutritional issues.

We have edited the punctuations errors and  revised the text to make it easier to read. 

Author Response File: Author Response.docx

Reviewer 3 Report

My compliments to the author for the review presented. The data is presented well but introduction must be improved. The subject of hyperglyemia in the hospitalized patients is undervalued. Do you have any data for outcome o mortality in ICU patients? Do you have any data regarding the period of covid as in the "atherogenic dyslipidemia on admission is associated with poorer outcome in people with and without diabetes hospitalized for covid-19"? it will be important add also data of that period.
For the introduction maybe you can add although we have the diagnosis of diabetes refer that we have availble new treatments as referred in "recent pharmacological options in type 2 diabetes and Synergic Mechanism in cardiovascular disease"

minor editing is necessary

Author Response

Thank you for reviewing our manuscript and your constructive suggestions. We have added references to reflect on newer treatments for diabetes and COVID -19 patients presenting with hyperglycemia. We have revised the introduction section and added reference and data on hospital outcomes in ICU patients  in hyperglycemia sections. English editing was done as well. 

Author Response File: Author Response.docx