Prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients

Abstract

Context:Despite the availability of efficacious anti-diabetic drugs, which act by different mechanisms to reduce the blood-glucose, the majority of people with diabetes on anti-diabetic drug therapy, have poor glycemic control and diabetic vascular complications.Aim and Objectives:The aim was to study the prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients attending tertiary care teaching hospital in Navi Mumbai.Materials and Methods:A prospective, cross-sectional, observational survey was carried out in 100 patients of diabetes mellitus attending diabetes outpatient/medicine outpatient departments, to assess their prescribing pattern of anti-diabetic drugs, and their blood-glucose level was measured by Accu-Chek Active glucometer to determine their glycemic control.Results:Average number of anti-diabetic drugs per prescription was 1.4. Sulfonylureas were the most commonly prescribed class, but metformin (biguanide) was the commonest prescribed individual drug among oral hypoglycemic agents (OHA). Fixed dose combination of biguanide and sulfonylurea was prescribed commonly. Monotherapy dominated over polytherapy and there was a higher percentage of use of insulin in Type 2 diabetics. Only 41% of patients on anti-diabetic therapy had optimal glycemic control. The association between anti-diabetic therapy along with lifestyle modification and glycemic control was statistically significant (P = 0.0011).Conclusions:OHAs still dominate the prescribing pattern, but there was a shifting trend toward the use of insulin preparations in the management of Type 2 diabetes mellitus. In achieving optimal glycemic control, the efficacy of the anti-diabetic drugs was only 41%; therefore intensification of current drug treatment as well as planning multiple drug interventions with lifestyle modification is necessary.

Assessment of Medication Adherence in Type II Diabetic Patients: A Cross-sectional Study

“…15,16 Worldwide, studies on medication adherence among diabetic patients have shown a wide variation. [17][18][19][20][21][22][23][24] In India, [25][26][27] Limited studies from Southern and Northern regions of India have documented wide variation in the medication adherence and have addressed the issues of nonadherence in diabetic patients. 21,[28][29][30][31][32][33] AIM Therefore, this study was conducted to assess the medication adherence among type II diabetic patients attending a tertiary care hospital in Navi Mumbai, India.…”

An Assessment of Anti-hyperglycemic Drug Utilization Patterns and Adherence to AACE/ACE 2015 Guidelines in South Indian Tertiary Care Teaching Hospital

“…Increased insulin use was also observed in many other studies. 19 Additionally, the use of DPP-4i was found to have significant importance in therapy. There were studies published that use of DPP-4i in both dual and triple therapy is safe and efficacious option.…”

Gambaran Terapi Diabetes Melitus Tipe 2 dengan Komorbid Hipertensi di Rumah Sakit X Pekanbaru

“…5,7 Hasil ini senada dengan penelitian RS Mumbai India pada 100 pasien DM tipe 2 yang sebagian besar (56,4%) mendapatkan terapi OAD dibanding insulin (43,6%), namum pada penelitian ini terapi tunggal OAD lebih banyak digunakan dibandingkan kombinasi. 8 Penelitian ini juga mendapatkan hasil OAD oral terbanyak digunakan sebagai terapi adalah metformin (90,3%), diikuti oleh golongan pemicu sekresi insulin yaitu sulfonilurea. Metformin merupakan OAD dari golongan penghambat glukoneogenesis.…”

“…Golongan penghambat glukoneogenesis dapat memperbaiki ambilan glukosa sebesar 10-40%, mengurangi glikogenolisis dan glukoneogenesis sehingga dapat menurunkan kadar glukosa hati. 3,8 Hal ini berbeda dengan penelitian Mumbai india didapatkan penggunaan golongan penghambat glukoneogenesis di rumah sakit urutan kedua setelah sulfonilurea. 8 Dosis harian metformin tersering digunakan pada penelitian ini adalah 1000 -1500 mg. Penggunaan metformin dimulai dari dosis 500 mg 2 x/hari atau 850 mg 1 x/hari.…”