DRUG UTILISATION PATTERN OF ANTIDIABETIC DRUGS AMONGST OBESE DIABETIC PATIENTS IN A TERTIARY CARE HOAPITAL- AN OBSERVATIONAL STUDY

Vartika Srivastava, Sougata Sarkar, Jyotirmoyee Jena, Manjushree Mohanty

Abstract


Background: The principal aim of drug utilisation studies (DUS) is to facilitate the rational use of drug  in a population.DUS is an essential part of pharmacoepidemiology and pharmacoeconomic as it describes the extent,nature and determinants of drug exposure. Diabetes at present appears as a common non communicable disease. It leads to high morbidity and mortality due to the disease itself and its diverse complications like coronary artery disease, hypertension, renal complication, retinal damage, neurological disorders, incidence of stroke at different sites, generalised infections etc. With such multifactorial background of high prevalence , progressive nature of the disease, availability of multiple therapeutic regimens prescribed on trial and error basis, the treatment is individualised and neither complete nor satisfactory. Objectives: This study was undertaken to analyse the current prescribing pattern in obese patients of type 2 diabetes mellitus with regard to drug/drugs precription  ,dose, duration of treatment  and frequency of change of drugs. Methods: This is a  prospective, parallel group, comparitive observational study. The enrolled obese patients were divided as a)New diabetic b) Old diabetic(<3 years duration). Each category was further divided into four subgroups according to the treatment recieved a)Monotherapy-only Metformin b)Combination therapy- Metformin+another antidiabetic groups,preferably sulfonylureas, alphaglucosidase inhibitors or DPP 4 inhibitors c)Triple therapy( Metformin+SU+Voglibose or Gliptins or Glitazones) d)Insulin with other oral hypoglycemic drugs. Results: In the study of prescribing pattern, it was observed that most prescriptions in this tertiary care hospital were found to be in compliance with the ADA guidelines. Metformin monotherapy was prescribed  as initial treatment. Sulphonylureas/ Gliptins / Alpha glucosidase inhibitors/  thiazolidinediones  were  used as second line therapy mostly anyone,  in addition to metformin or as monotherapy according to patient requirement, tolerability and cost.Conclusions: The antidiabetic medications prescribed in this hospital,were found to be in compliance with  ADA guidelines with metformin being the first line of treatment followed by sulfonylureas and alphaglucosidase inhibitors


Keywords


Diabetes, Obese, Pre-obese, FBS, PPBS, HbA1C

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References


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