Antidiabetic drug utilization in type 2 diabetes mellitus patients at a tertiary care hospital in South India

Abstract

Background: Diabetes mellitus in India is estimated to be 77 million individuals affected by this disease, which is likely to go up to 134 million by 2045. Globally, it is projected at 9.3% in 2019 (463 million persons). It is projected to increase to 10.2% by 2030 (578 million) and 2045. Aims and Objectives: The study aimed to analyze antidiabetic drug utilization in type 2 diabetes mellitus patients in south India tertiary care hospital. Materials and Methods: This cross-sectional and observational study was conducted at the endocrinology Department of a Tertiary Care Medical College and Hospital in south India over 12 months. After obtaining informed consent, diagnosed adult type 2 diabetes patients receiving any antidiabetic drugs were included in the study. Demographic, and clinical proportions of each class of antidiabetic drug were analyzed. Results: Out of 364 patients, age distribution (years): 30–39 (11%), 40–49 (25%), 50–59 (34%), 60–69 (22%), and >70 (8%); Gender: male (37%) and female (63%); duration of diabetes (years): newly diagnosed (7%), <5 years (21%), 5–10 years (24%), and >10 years (43%); body mass index (kg/m2): range 21–29.6, hemoglobin A1C (%): Range 6.1–9.4. Associated comorbidities: hypertension (38%), dyslipidemia (21%), diabetic nephropathy (7%), diabetic retinopathy (2%), diabetic foot ulcer (4%), and diabetic retinopathy (2%). Metformin is the most common drug used in all regimens, with over 90% of participants using it in monotherapy and over 80% of participants using it in combination with other drugs. Conclusion: In almost all the patients, the treatment initiation was done by metformin; in two-thirds of patients’ treatment, intensification was done with glimepiride, insulin, Dipeptidyl peptidase-4is, or pioglitazone as dual, triple, or quadruple drug combination regimen where metformin was also an integral part of the combination regimen.