scholarly journals Real-world Evaluation of glycemic control and hypoglycemic Events among type 2 Diabetes mellitus study (REEDS): a multicentre, cross-sectional study in Thailand

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031612
Author(s):  
Bancha Satirapoj ◽  
Thongchai Pratipanawatr ◽  
Boonsong Ongphiphadhanakul ◽  
Sompongse Suwanwalaikorn ◽  
Yupin Benjasuratwong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Weight Gain ◽  
Goal Attainment ◽  
Tertiary Care ◽  
Treatment Compliance ◽  
Cross Sectional ◽  
Tertiary Care Hospitals

ObjectivePatients with type 2 diabetes mellitus (T2DM) often experience hypoglycaemia and weight gain due to treatment side effects. Sulfonylureas (SU) and the combination of SU and metformin (SU+MET) were the most common monotherapy and combination therapies used in Thailand tertiary care hospitals. This study aimed to assess the glycaemic goal attainment rates, hypoglycaemic episodes, weight gain and treatment compliance among patients with T2DM receiving SU or SU+MET.Research design and methodsA multicentre cross-sectional survey and retrospective review was conducted in five tertiary care hospitals, Thailand. Patients with T2DM aged ≥30 years were included consecutively during a 12-month period. Glycaemic control, experiences of hypoglycaemia, weight gain and compliance were evaluated. Glycaemic goal attainment was defined by HbA1clevel less than 7%.ResultsOut of the 659 patients (mean age (±SD)), 65.5 (10.0) years and median duration of T2DM (IQR), 10 (5–15) years), 313 (47.5%) achieved the glycaemic goal. HbA1clevels in the patients with goal attainment was significantly lower compared with those without (6.3%±0.5% vs 8.1%±1.2%, p<0.001). Goal attainment was significantly lower among patients treated with SU+MET than those treated with SU alone (43.5% vs 63.0%; OR 0.45, 95% CI 0.31, 0.66, p<0.001). A third of patients reported experiencing hypoglycaemia (30.7%) and weight gain (35.4%). Weight gain in the SU+MET group was lower than those receiving SU alone (33.1% vs 44.6%, p=0.015), but there was no difference in hypoglycaemic events. Major events in the previous 12 months were experienced by 68 patients, most commonly congestive heart failure and ischaemic heart disease. Approximately half of the patients (52.2%) reported not always taking their medication as prescribed.ConclusionsAmong patients with T2DM receiving SU or SU+MET, only about half of the patients achieved glycaemic goal and compliance with the treatment. Hypoglycaemia and weight gain posed a significant burden with risk of weight gain higher in the SU group.

scholarly journals Assessment of quality of life of type-2 diabetes mellitus patients in tertiary care teaching hospital in North India

2019 ◽  
Vol 9 (1) ◽  
pp. 107
Author(s):  
Aditya Parashar ◽  
K. K. Jha ◽  
Arun Kumar ◽  
Sheetal Singh Tomer ◽  
Dharmendra Singh Yadav ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
North India ◽  
Cross Sectional ◽  
Physical Strength

Background: Quality of life (QoL) is a standard indicating a person’s life in better condition as compared to a diseased person or patient. Diabetes itself is not a dangerous disease if managed properly, but it becomes life-threatening after a certain time period because of the patient’s poor interest in disease management and treatment adherence. Diabetes mellitus is an endocrine system disorder that invokes lack of insulin secretion in the bloodstream. The study was conducted to assess the QoL of type-2 diabetes mellitus patients with QoL instrument.Methods: Questionnaire based cross-sectional, prospective study was conducted at Teerthanker Mahaveer Hospital, Moradabad, for a duration of 6 months from January - June 2019, on 196 patients of type-2 diabetes mellitus.Results: On an average 56.5% people have accepted that due to the diabetic condition their working proficiency is decreased. 80.3% of patients have accepted that they were facing problems due to diabetic symptoms. Similarly, 84% of patients have accepted that the ongoing treatment was quite expensive than their expectations. Finally, the last section of the patient’s emotional/mental satisfaction showed that 49.7% of patients were very satisfied with their family support while 13.7% of patients were not satisfied.Conclusions: QOL instrument for Indian diabetes patient’s instrument helped to evaluate the patient’s physical strength, psychological strength of the patient during disease condition, the response provided from the family members and relatives, the economical status of the patient and its effects on their living.

Type 2 Diabetes Mellitus with Early Dry Skin Disorder: A Comparison Study between Primary and Tertiary Care in Indonesia

2021 ◽  
Vol 17 ◽  
Author(s):  
Lili Legiawati ◽  
Kusmarinah Bramono ◽  
Wresti Indriatmi ◽  
Em Yunir ◽  
Aditya Indra Pratama
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Early Stage ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Dry Skin ◽  
Cross Sectional

Background: The prevalence of type 2 diabetes mellitus (T2DM) in Indonesia has continued to increase over the years. Management of T2DM is challenging across clinical settings, including primary and tertiary care. Uncontrolled T2DM puts patients at risk of the development of T2DM complications, especially early-stage dry skin that is neglected by most of the patilents. This study aimed to investigate the comparison between the T2DM management profile and dry skin clinical profile of T2DM patients in primary care and tertiary care settings. Methods: The study was conducted as a cross-sectional epidemiological study by comparing T2DM patient profiles in primary and tertiary care. The data collected included sociodemographic, clinical, and laboratory data that were correlated with T2DM and early dry skin related-T2DM. This study included early dry skin within the SRRC score of 3-11 and excluded infection, ulcer, and severe erythema. Results: The patients in primary and tertiary care presented poorly controlled T2DM with median HbA1c levels of 7.8% and 7.6%. The patients in primary care also presented with high triglyceride, 179 mg/dl. Furthermore, several significant differences were found in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin). Conclusions: Significant differences in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin) might be affected by the parameter of T2DM glycemic control (Blood pressure (BP), body mass index (BMI), HbA1c, random blood glucose (RBG), and triglyceride).

scholarly journals Prescribing pattern of oral anti-diabetic agents in type 2 diabetes mellitus patients in a tertiary care hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 956
Author(s):  
Taruna Sharma ◽  
Rajit Sahai ◽  
Suman Bala ◽  
Dilip C. Dhasmana ◽  
Nidhi Kaeley
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Combination Therapy ◽  
Tertiary Care ◽  
Fixed Dose ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional

Background: Prescription pattern studies are a tool for assessing the prescribing, dispensing and distribution of medicines. The main aim of assessing prescribing pattern is to facilitate rational use of medicines. So the main aim of the study was to assess the prescribing pattern of oral anti-diabetic agents in type 2 diabetes mellitus, to assess the rationality of the prescribed drugs and also to assess the pattern of co-morbid conditions associated with type 2 diabetes mellitus in a tertiary care hospital.Methods: This cross sectional study was conducted in the Department of Pharmacology in collaboration with Department of General Medicine. Study was conducted from 1st June 2016 to 31st Aug 2016 (3 months). A total of 100 patients were enrolled after taking written informed consent. A structured case recording form was used to record demographic details and prescription details. The rationality of prescriptions was assessed using American Diabetes Association guidelines 2015.Results: Majority of the patients were prescribed combination therapy (54%) followed by monotherapy (46%). Oral anti-diabetic agents used as monotherapy other than metformin were inappropriate. Among the patients receiving combination therapy majority were receiving a fixed dose combination which were inappropriate.Conclusions: Majority of the patients were receiving fixed dose combinations without justifiable pharmacokinetic/pharmacodynamic benefits. Such kinds of studies are required to improve rationality of prescription of drugs, decreasing morbidity and mortality of patients and decreasing the cost of treatment.

scholarly journals Prescribing Pattern of Antihypertensive Drugs in Hypertensive Patients with Non-Insulin Dependent Diabetes Mellitus at Tertiary Care Hospitals in Karachi Pakistan

2021 ◽  
pp. 107-112
Author(s):  
Syed Wajid Shah ◽  
Mirza Tasawer Baig ◽  
Syed Imran Ali ◽  
Qurratul ain Leghari ◽  
Aisha Jabeen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Fixed Dose ◽  
Prescribing Pattern ◽  
Hypertensive Patients ◽  
Tertiary Care Hospitals

Introduction: Hypertension (HTN) is one of the most serious public health issues in the world, affecting around 1.4 billion people worldwide. HTN is becoming highly prevalent in Pakistan, about more than 33% of people over the age of 40 years suffering from the HTN. The illness burden is continuously growing due to the incorrect medicine prescriptions, a lack of education, and a lack of patient compliance. The existence of comorbidities such as Diabetes Mellitus (DM) should be properly considered while choosing an Antihypertensive medication. Similarly, the prescriptions of Oral Hypoglycemic agent’s appropriate consideration are essential. Oral hypoglycemic medications are divided into several categories. Physicians face a challenge in rationally selecting a regimen from a variety of classes, and the situation becomes more complicated when the patients have additional non-communicable illnesses, such as HTN. The combination therapy of ailments not only effects the patient`s economic status but also effects the quality of life. Objective: To study the prescribing pattern of Antihypertensive drugs in Hypertensive patients with Type 2 Diabetes Mellitus at Tertiary care hospitals in Karachi, Pakistan. Methods: A cross sectional study was undertaken for six months in medicine outpatient department at tertiary care hospitals of Karachi. The study population was observed for the prescribed pattern of Antihypertensive medicines by assessing the 300 prescriptions of Hypertensive patients with Type 2 Diabetes Mellitus. Statistical analysis was performed using SPSS version 20. Data was presented as frequencies and percentages. Results: The result revealed that the most commonly prescribed single antihypertensive drug was Enalapril 66 (22%) followed by Amlodipine 63(21%), Ramipril 57(19%), Diltiazem 33(11%), Lisinopril 21(7%) losartan k 6(2%), Nebivolol 6(2%), Bisoprolol 3(1%). Dual therapy included Ramipril and Nebivolol 1(0.33%) and Amlodipine+Valsartan 35 (11.67%), Amlodipine+Valsartan+HCTZ 9 (3%) were the antihypertensive drugs prescribed as fixed dose combinations. Conclusion:  The present study shows Enalapril belonging to Angiotensin Converting Enzyme Inhibitor (ACEI) class was frequently used as single Antihypertensive agent and Amlodipine+Valsartan belonging Calcium Channel Blockers (CCBs) and Angiotensin Receptor Blockers (ARBs) was the most frequently prescribed fixed dose combination while managing Hypertension of Hypertensive patients with Type 2 Diabetes Mellitus.

scholarly journals Pharmacoeconomic evaluation in cost of illness in type 2 diabetes mellitus patients in a tertiary care hospital

2017 ◽  
Vol 6 (10) ◽  
pp. 2334
Author(s):  
Tushar R. Bagle ◽  
Vijay A. Vare ◽  
Alankar Nimgade ◽  
Rohankumar C. Hire ◽  
Yogesh Sharma ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Pharmacoeconomic Evaluation ◽  
Exclusion Criterion ◽  
Care Hospital ◽  
Cross Sectional

Background: India is expected to bear the burden of world’s greatest increase of diabetes population. This burden needs to be considered in terms of costs.Methods: Cross-sectional study was done in type 2 diabetes mellitus 100 patients that attended Medicine OPD. Prior to enrollment Institutional Ethics Committee permission was taken. Written Informed consent was taken. Demographic information related to Education, Occupation and Income was taken down. Also Information related to diagnostic tests and medications were documented. Inclusion criterion were 18-70 years of either gender diagnosed by Physicians in OPD as type 2 diabetes, willing to participate and have followed in OPD for at least one year. The Exclusion criterion was Critically ill or unconscious patients and Pregnant women. Direct and indirect costs were calculated.Results: The average age was 56.31±10.50 years. The average fasting blood glucose was 120.65±22.70mg/dl. The average cost per month for investigations was 159.74±128.06. Annual visit to OPD was 13.06±7.35. Time loss per visit was 5.62±1.29 hours and of accompanying person was 6.55±3.87 hours. There were 2 from Lower and 63 from Upper Lower socioeconomic class. There were 41 patients having diabetic complications. The indirect cost was around 5838.51 and direct cost was around 19925. Total cost per annum per patient was around 32361.27 INR.Conclusions: There is need for strategies to reduce the cost burden. There is also needed to design financial systems for diabetes related nationwide health programs.

scholarly journals Dyslipidemic profile in Type 2 Diabetes Mellitus: A hospital-based study from Eastern Nepal

2020 ◽  
Vol 7 (2) ◽  
pp. 64-70
Author(s):  
Binod Kumar Lal Das ◽  
Netra Prassan ◽  
Mohammad Faiz Ansari ◽  
Kanishk Agrawal ◽  
Saloni Tripathi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Major Type ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: Dyslipidemia is highly prevalent in Type 2 Diabetes Mellitus (T2DM). It plays a major role in the pathogenesis for diabetic complications. This study intends to exemplify the pattern of dyslipidemia prevalent in T2DM patients attending tertiary care centre of Eastern Nepal. Material and methods: This is a hospital based cross-sectional study conducted in the T2DM patients visiting the routine biochemistry laboratory for their routine blood investigations. 226 patients were included who fulfilled the inclusion criteria. Biochemical parameters were analyzed in routine biochemistry laboratory in cobas c311 autoanalyzer. Results: Out of the 226 T2DM patients, 51% were female and 49% were male respectively. The mean age group was 54.15 ± 12.62 years. Mean value of, HbA1c level, total cholesterol, TG, HDL and LDL was 8.16 ± 2.59 %, 289.04 ± 47.83, 297.77 ± 119.64, 35.62 ± 12.64 140.88 ± 40.58 respectively. HbA1c was significantly correlated with the lipid profile in T2DM patients (p < 0.05). Conclusion: The findings from the present study depicts that the prevalence of dyslipidemia is higher in T2DM in our centre with hypertriglyceridemia being the major type of dyslipidemia in these patients. In addition, male exhibited higher rate of dyslipidemia compare to their female counterparts respectively.

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