Assessment of prescribing pattern in uncomplicated and complicated Type 2 diabetes mellitus in a tertiary care hospital

Abstract

Background: Diabetes mellitus (DM) is a major public health problem globally and in India. Many studies in the past have documented inadequate glycemic control and complication rates among the Indian diabetic population due to inappropriate or inadequate pharmacological treatment. Studies assessing the prescription pattern are also very scare from the country. The present study has been conducted with the objective of assessing the profile of diabetic patients admitted to a tertiary care teaching hospital and the prescription pattern of anti-diabetic medication among them. Aims and Objectives: The aimed to analyze the current prescribing patterns for patients with both uncomplicated and complicated Type 2 DM in a tertiary care hospital and to identify the most commonly prescribed antidiabetic medications and their combinations in both uncomplicated and complicated cases. Materials and Methods: The present study was a retrospective case record review of 136 patients with Type 2 DM admitted in the ward of general medicine department of a tertiary and is teaching hospital. Results: The mean age was 54.39 ± 12.46 years and 61.03% of participants were males. Comorbidities such as systemic hypertension were present in 21.32% of participants and hyperlipidemia was present in 11.76% of participants. The proportion of subjects, who had complicated DM, was 52.21%. Among the study population, 77 (56.62%) had oral hypoglycemic agents (OHA) alone, 27 (19.85%) had insulin alone, and 32 (23.53%) had Insulin + OHA. Among the study population, 70 (51.47%) had single OHA, 32 (23.53%) had dual combination of OHA, and 7 (5.15%) had triple combination OHA. The majority (53.70%) people were taking metformin, 20 (14.71%) people were taking glimepiride, 16 (11.76%) people were taking glibenclamide, 13 (9.56%) people were taking gliptins. Among the study population, 34 (25%) people were taking actrapid, 32 (23.53%) people were taking mixtard, and 10 (7.35%) people were taking lup Insulin. Among the study population, 32 (23.53%) had anti-hypertensive drugs, 19 (13.97%) had statins, 14 (10.29%) had antiplatelet, 12 (8.82%) had antibiotics and 4 (8.94%) had diuretics. The mean fasting blood sugar at admission was 178.51 ± 69.56 g/dL and at the discharge was 123.23 ± 24.92 g/dL and the mean difference (55.29) between two groups was statistically significant (P < 0.001). The mean postprandial blood sugars at admission was 228.92 ± 67.03 g/dL and at the discharge was 166.66 ± 30.73 g/dL, and the mean difference (55.29) between two groups was statistically significant (P < 0.001). Conclusion: The treatment intake was inadequate and glycemic control was poor in majority of the diabetic population. There is high reliance on metformin and sulfonylureas and insulin is underutilized even in patients with poor glycemic control. There is strong need to optimize the therapy in diabetic patients.