Current practice of insulin and oral hypoglycaemic agents treatment of diabetes mellitus type 2 patients according to diabetes mellitus register data analysis in the city of Donetsk, Ukraine

Abstract

ADA-EASD consensus algorithm of type 2 diabetes mellitus (T2) treatment, published in 2006, expects a transition of type 2 diabetics from metformin (M) and sulphanylureas medications to insulinwhich assumes awide use of oral hypoglycaemic agents (OHA) and/or insulin only in a significant fraction of patients. In Ukraine patients are provided with free access to insulin medication, but treatment with OHA is usually paid for by the patients themselves. Accounting the qualitative heterogeneity of OHA, an analysis of their present use structure on the population level had been conducted. A cross-sectional population investigation, based on the T2 register analysis of Donetsk City (adult population in 2003–858.2 thousand persons) had revealed a low level of combined OHA+ insulin treatment in Donetsk City (1.7%). The fraction of M use in the structure of Donetsk City’s OHAwas 19.4%, out of 2252 OHA prescriptions, the degree of thismedication’s use by different GPs significantly varied. The average age of patients receiving M and some other OHA was much lower (p<0.001) than in those being treated with glibenclamide, which is the most affordable. In summary, the elderly persons, who appear to be the most vulnerable social category of T2 patients, probably have limited access to the relativelymore expensive OHA, like M and glyclazide, which are believed to have the least side effects.