scholarly journals Prescribing pattern of anti diabetic drugs in patients suffering from type 2 diabetes mellitus with co-existing hypertension in a tertiary care teaching hospital

Author(s):  
Jay Kumar Sharma ◽  
Shailesh P. Parmar

Background: Diabetes mellitus and hypertension frequently co-exist in a patient. In such patients, the risk of complications, morbidity and mortality increases. One should be careful in management and choosing drugs. Authors undertook this study to understand the prescribing pattern of the physicians in diabetic hypertensive patients.Methods: This cross sectional, observational study was conducted in type 2 diabetic outdoor patients with co-existing hypertension, for duration of one year. We used descriptive statistics to analyze data of 615 patients to determine prescribing pattern of drugs.Results: 93.17% of patients were more than 40 years of age. Ratio of female to male patients was 1.30. Mean duration of diabetes was 5.81 years. Multi drug anti diabetic regimes (54.47%) were common than monotherapy (43.90%). Commonly prescribed anti diabetic drug groups were biguanides (89.27%), Sulfonylureas (43.90%) and insulin (15.28%). Metformin (89.27%), glibenclamide (29.11%) and insulin (15.28%) were commonly prescribed anti diabetic drugs. Metformin was the most common monotherapy drug and biguanide + sulfonylurea was the most common two drug combination. Commonly prescribed drugs for co-morbid conditions were enalapril (83.41%), aspirin (30.41%), amlodipine (29.76%) atorvastatin (27.32%) and famotidine (26.34%). Average number of drugs prescribed in a prescription was 4.65. Prescriptions with injections were 15.93% and with brand names were 13.15%.Conclusions: Prescribing pattern of drugs was as per current practices and recommendations of guidelines. Still, there is room for improvement in choice of drug, prescribing drug with generic name and choosing drug from essential medicine list.

Author(s):  
Taruna Sharma ◽  
Rajit Sahai ◽  
Suman Bala ◽  
Dilip C. Dhasmana ◽  
Nidhi Kaeley

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.


Author(s):  
Sujeet A. Divhare ◽  
Satyashil Ingale

Background: Potential importance of drug –drug interactions (DDIs) is increasing as polypharmacy becomes more prevalent. Because additional data on the incidence and pattern of potential DDIs among diabetic patients are lacking in India, and supplemental pharmacodynamic or clinical outcome information is needed to address importance of a drug- drug interaction. Aim and objectives: To identify and analyze the pattern of DDIs in patients being prescribed anti-diabetic drugs in a tertiary care hospital. Material and Methods: This prospective cross-sectional study was carried out for a period of three months in 200 Type 2 diabetes mellitus (Type 2 DM) patients who were taking at least one antidiabetic agent during the period of past six months, of any age and either sex admitted in medicine ward of a tertiary care teaching hospital. Only one prescription was included for each patient on his/her 3rd day of hospitalization in the ward. Results: A total of 1217 drugs were prescribed in 200 prescriptions, resulting in an average of 6.1 drugs per prescription. A total of 637 potential DDIs were noted. The majority were seen in middle aged and elderly people. No overall difference was detected in the patients on insulin or metformin therapy taking or not taking additional drugs with the potential to interact. Worse control was found in the group of patients on sulphonylurea therapy taking interacting drugs (P <0.05). This difference was most marked in the group of patients over 60 years of age, who also had the highest intake of potentially interacting drugs (57%; <35 years-37%). Conclusion: Antidiabetic drugs have numerous interactions. A good practice is to use a drug­–drug interaction checker if any questions arise, several are available online. Quality care starts with the clinician obtaining a complete medication list for each patient at the start of each visit. Keywords: diabetes mellitus, drug interactions, hypoglycemic agents, drug therapy, co-morbidity, polypharmacy


2020 ◽  
Vol 7 (12) ◽  
pp. 1815
Author(s):  
Mausam Jain ◽  
Pramod R. Jha ◽  
Gaurang Patel

Background: Aim was to study prevalence of thyroid dysfunction in type II diabetes mellitus (T2DM) patients.Methods: The present study was a cross sectional observational study, which focused on cases of diabetes mellitus. Study was conducted in Departments of Medicine, SBKS MI & RC, a tertiary care centre for a period of 6 months. All the patients of T2DM were included. Total of 263 patients were enrolled which involved indoor, outpatient and diabetic clinic attending patients. A detailed history taking, clinical examination and relevant investigations (Hb%, Total count, platelet count, serum creatinine, FBS, PP2BS, HbA1C, S.TSH, F.T3 and F.T4). Appropriate statistical analytics were used and important correlations and conclusions were drawn.Results: A study of thyroid dysfunction (TD) in T2DM patients which included 263 diabetic patients, out of them 67 had thyroid dysfunction. Out of these 67 patients 43 were female and 24 were male. This suggests that female was more prone to thyroid dysfunction than males. Out of 67 TD patients, 42 were above the age of 50 year. So, as the age increases the prevalence of TD also increases thyroid dysfunction also depends on the glycaemic control of the patients. Out of 67 patients 22 patients had>8.0 HbA1C level. In our study we found that as the glycaemic control became poorer the prevalence of TD increase in hypothyroid but not in hyperthyroidism.Conclusions: Following conclusions were drawn from this study TD is more common in female than male, more after the age of 50 year, in T2DM patients. Hypothyroidism is more common with poor glycaemic control and long duration of T2DM patients. But for hyperthyroidism data which we evaluated was not significant and further conclusion bigger study is needed.


2016 ◽  
Vol 04 (02) ◽  
pp. 133-136 ◽  
Author(s):  
Amit Thour ◽  
Ramninder Nagra ◽  
Arunjeet Gosal ◽  
Tejasav Sehrawat ◽  
Subhash Das ◽  
...  

Abstract Background: Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been limited data, especially from India, which has specifically examined whether diabetes mellitus is associated with an increased likelihood of comorbid anxiety. Aim: The aim was to estimate the prevalence of anxiety in patients with diabetes and to determine the association of anxiety with age, sex, and other related parameters. Setting: Endocrine clinic, tertiary care hospital. Design: Cross-sectional. Materials and Methods: The study was cross-sectional carried out in endocrinology clinic of tertiary care hospital in North India. Cases were patients with type 2 diabetes mellitus above 30 years of age. Anxiety was assessed using the generalized anxiety disorders 7-item (GADs-7) scale. The relationship with a sociodemographic profile, duration of diabetes, hypertension, and microvascular complications was also analyzed. Results: Seventy-three subjects (42.5% females) with mean age 50.8 ± 9.2 years were evaluated. The prevalence of anxiety was 34%. Severe anxiety (GAD-7 score ≥15) was present in three (4%) subjects, moderate anxiety (GAD-7 score ≥10) was present in six (8%) subjects, and mild anxiety was present in 16 (22%) of subjects. Anxiety increased with fasting plasma glucose, hypertension, was more in women, but the differences were not statistically significant. Conclusions: Our study demonstrates a higher prevalence of anxiety in patients with type 2 diabetes. No factor was significantly associated with anxiety. Therefore, anxiety should be assessed in each and every patient, irrespective of other factors.


2014 ◽  
Vol 5 (1) ◽  
pp. 54
Author(s):  
Chandrashekaran Girish ◽  
Sadasivam Balakrishnan ◽  
Dakshinamurthy Nishanthini ◽  
BalanAravinda Kumar

Author(s):  
Aditya Parashar ◽  
K. K. Jha ◽  
Arun Kumar ◽  
Sheetal Singh Tomer ◽  
Dharmendra Singh Yadav ◽  
...  

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.


2020 ◽  
Vol 10 (3-s) ◽  
pp. 91-97
Author(s):  
A B Anila ◽  
P. Shaji Ancy ◽  
B S SREELEKSHMI ◽  
NM Mahesh ◽  
B A Vishwanath

Aim of the study: To study the prescribing pattern of multivitamins in type-2 DM in tertiary care hospitals. Materials and methods: Human ethical approval was taken from human ethical committee, ABIPER Bangalore. The diabetic patients who satisfied the study criteria were enrolled. The patients data’s were collected in specially designed documentation form. The collected data’s were assessed using descriptive statistics. Results: The study was conducted in 158 patients in which most prescriptions [72.17%] contains water soluble vitamins+minerals. Multivitamins with or without minerals were prescribed for 90[79.76%] and 30[20.24%] days respectively. Multivitamins [100%] were given orally once a day. For indication fatigue [29.11%], water soluble vitamins+minerals were prescribed mostly. Many DM-2 patients were prescribed with water soluble vitamins+minerals which contain vitaminC and calcium carbonate as main constituents. Some of multivitamins doses were showing compliance as per FDA dose recommendations. Tablet formulation containing fat soluble vitamins+minerals[25.31%] were prescribed mostly. Conclusions: Mostly water soluble vitamins+minerals were prescribed for DM-2 patients. Multivitamins with or without minerals were prescribed for 90and30 days respectively. All multivitamins were prescribed in oral route. Mostly water soluble vitamins+minerals were prescribed for fatigue illness associated with DM-2 in which vitamin C and calcium carbonate were the main constituents. Some of the prescribed multivitamin doses were within the FDA recommended dose range. Tablet formulations were frequently prescribed with oral anti-diabetic drugs. Keywords: Multivitamins, Diabetes mellitus, Hypertension, Prescription.


Author(s):  
Rucha M. Shinde ◽  
Anand S. Kale ◽  
Mahadeo P. Sawant

Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.


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