| Peer-Reviewed

Anti-diabetic Drugs Utilization in Type 2 Diabetic Patients in AL-Nasiriya Governorate / Iraq

Received: 28 August 2017     Accepted: 9 October 2017     Published: 10 November 2017
Views:       Downloads:
Abstract

To study the utilization pattern of anti-diabetic drugs in type 2 diabetic patients and to evaluate the association of diabetes with demographic details and it's metabolic control. The study was carried out on 100 type 2 diabetic patients who visited AL- Nasiriya center for diabetes and endocrinology. Demographic details and complete prescriptions drugs, FBS (fasting blood sugar), HbA1c and BMI (body mass index) were recorded. A total of 100 type 2 diabetic patients, 27(27%) were males and 73(73%) were females. The greatest number of patients, 43%, were in the age group of 51-60 years. Obesity (BMI ≥ 30) were found in 51% of patients especially females 45(61.3%). Poor glycemic control (HbA1c ≥ 9) were found in 65% of the patients. Oral anti-diabetic drugs were prescribed in 53%, 16(60%) were males and 37 (50.6%) were females. Biguanide (metformin) alone, 22%, was the most common anti-diabetic drugs prescribed. Biguanides (metformin) and sulfonylurea combination, 19%, was the commonest anti-diabetic drugs combination. Insulin preparations alone were used in 23% of the patients and Novomix was the commonest type (10%). We concluded that oral anti-diabetic drugs were the most common prescribing drugs. Metformin was the commonest prescribing anti-diabetic drugs. Metformin and sulfonylurea being the most frequent combination prescribed. There were increasing in the use on insulin preparations in the treatment of type 2 diabetic patients. In achieving optimal glycemic control, the efficacy of anti-diabetic drugs was only 10%, planning of more intensification anti-diabetic treatment is necessary.

Published in American Journal of Internal Medicine (Volume 5, Issue 6)
DOI 10.11648/j.ajim.20170506.12
Page(s) 117-124
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Antidiabetic Drugs, Type 2 Diabetes Mellitus, Glycemic Control

References
[1] kyle Jeffrey starostka, pharm D candidates, a general overview of oral hypoglycemic for type 2 diabetes; Wyoming drug utilization review, 2008.
[2] Lawton C. Diabetes and aging: a growing concern. Perspectives 1994; 18(1):7-9.
[3] Ahmed, A. M. (2002) History of Diabetes Mellitus. Saudi Medical Journal, 23, 373-378.
[4] Olokoba, A. B., Obateru, O. A. and Olokoba, L. B. (2012) Type 2 Diabetes Mellitus: A Review of Current Trends. Oman Medical Journal, 27, 269-273.
[5] Stratton, I. M., Adler, A. I., Neil, H. A., Matthews, D. R., Manley, S. E., Cull, C. A., Hadden, D., Turner, R. C. and Holman, R. R. (2000) Association of Glycemia with Macrovascular Complication of Type 2 Diabetes (UKPDS 35): Prospective Observational Study. British Medical Journal, 321, 405-412.
[6] Raz, I., Wilson, P. W., Strojerk, K., Kowalska, I., Bozikov, V., Gitt, A. k., Jermendy, G., Campaigne, B. N., Kerr, L., Milicevic, Z., et al. (2009) Effects of Prandial versus Fasting Glycemia on Cardiovascular Outcomes in Type 2 Diabetes: The Heart 2D Trial. Diabetes Care, 32, 381-386.
[7] Davis, S. N. and Granner, D. K. (2001) Insulin, Oral hypoglycemic Agents and Pharmacology Endocrine Pancreas. In: Hardman, J. G. and Limbird, L. E., Eds., Goodman and Gilman's T Pharmacological Basis of Therapeutics, McGraw Hill, New York, 1526-1531.
[8] Campbell, I. W. and Lebovitz, H. (2000) Fast Facts-Diabetes Mellitus; What Is Type 2 Diabetes? 2nd Edition, Health Press Ltd., Oxford, 18-25.
[9] Cox, E. M. and Eleman, D. (2009) Test for screening and Diagnosis of Type 2 Diabetes. Clinical Diabetes, 4, 132-138.
[10] International Expert Committee (2009) International Expert Committee Report on the Role of AIC Assay in the Diagnosis of Diabetes. Diabetes Care, 32, 1-8.
[11] Hermansen K, Mortensen LS, Hermansen ML. Combining insulins with oral antidiabetic agents: Effect on hyperglycemic control, markers of cardiovascular risk and disease. Vasc Health Risk Manag. 2008;4:561-74.
[12] Sivaasankari V, Manivannan E, Priyadarsini SP. Drug utilization pattern of anti-diabetic drugs in a rural area of Tamilnadu, South India – A prospective, observational study. Int J Pharm Biol Sci. 2013;4:514-9.
[13] Gama H. Drug utilization studies. Arq Med. 2008;22:69-74.
[14] Davis SN. Insulin, oral hypoglycemic agents, and pharmacology of the endocrine pancreas. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th ed. United States of America McGraw-Hill; 2006. pp. 1613-45.
[15] Powers AC. Diabetes mellitus. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Lango DL, Jameson JL, editors. Harrison's Principles of Internal Medicine. 16th ed. New York: McGraw-Hill; 2005. pp. 2152-80.
[16] Intensive blood-glucose control with sulfonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK prospective Diabetes Study (UKPDS) Group. Lancet. 1998; 352: 837-53.
[17] Nathan, D. M., Buse, J. B., Davidson, M. B., Ferrannini, E., Holman, R. R., Sherwin, R., Zinman, B., American Diabetes Association and European Association for Study of Diabetes (2006) Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy: A consensus statements from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 29, 1963-1972.
[18] Misra B, Jain SK, Mehta Y. A study on availability and prices of medicines in India. National Pharmaceutical Pricing Authority. 2002. {Last accessed on 2013 Jul 20}.
[19] Nagpal J, Bhartia A. Quality of Diabetes care in the middle- and high-income group populace: The Delhi Diabetes Community survey. Diabetes Care. 2006;29:2341-8.
[20] Turner, R. C., Cull, C. A., Frighi, V. and Holman, R. R. (1999) Glycemic Control with Diet, Sulfonylurea, Metformin, or Insulin in Patients with Type 2 Diabetes Mellitus: Progressive Requirement for Multiple Therapies (UKPDS 49): UK Prospective Diabetes Study (UKPDS ) Group. Journal of American Nedical Association, 281, 2005-2012.
[21] Ohkubo Y, Kishihata H, Araki E, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complication in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995; 28:103-117.
[22] UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulfonylurea or insulin compared with conventional treatment and risk of complications in patients wiyh type 2 diabetes (UKPDS33). Lancet 1998; 352:837-853.
[23] Akila L, et al. Drug utilization study of oral antidiabetic drugs at a tertiary care hospital in Chennai. Int. J. Med. 2011; 1 (3):177-82.
[24] Dinesh KU, Subish P, Pranaya M. Pattern of potential drug-drug interactions in diabetic out-patients in a Tertiary Care Teaching Hospital in Nepal. Medical Journal of Malaysia. 2007;62(4):294-8.
[25] Tseng CH. The Epidemiological Transition of Diabetes Mellitus in Taiwan: Implication for Reversal of Female Preponderance from a National Cohort. The Open Diabetes Journal. 2009;2:18-23.
[26] Roy V, Rewaris S. Ambiguous drug pricing: A physician's dilemma. Indian J Pharmacol. 1998;30:404-7.
[27] Vengurlekar S, Patidar P, Bafna R, Jain S. Prescribing pattern of antidiabetic drugs in indore city hospital. Indian J Pharm Sci. 2008;70(5):637-40.
[28] Patel B, Oza B, Patel KP, Malhotra SD, Patel VJ. Pattern of antidiabetic drugs use in type-2 diabetic patients in a medicine outpatient clinic of a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2013;2:485-91.
[29] Willey CJ, Andrade SE, Cohen J, Fuller JC, Gurwitz JH. Polypharmacy with oral antidiabetic agents: An indicator of poor glycemic control. Am J Manag Care. 2006;12:435-40.
[30] Ben Abdelaziz A, Soltane I, Gaha K, Thabet H, Tlili H, Ghannem H. Predictive factors of glycemic control in patients with type 2 diabetes mellitus in primary health care. Rev Epidemiol Sante Publique. 2006;54:443-52.
[31] Hasamnis A, Patil S. Prescription pattern study in type 2 diabetes mellitus in an Indian referral hospital. Internet J Pharmacol. 2009;7:1.
[32] Sutharson L, Hariharan RS, Vamsadhara C. Drug utilization study in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003;35:237-40.
[33] Truter I. An investigation into antidiabetic medication prescribing in South Africa. J Clin Pharm Ther. 1998;23:417-22.
[34] National Diabetes Fact Sheet. American Diabetes Association. Available from: http:/www.diabetes.org/main/info/facts.
[35] Sivasankari V, Manivannan E, Priyadarsini SP. Drug utilization pattern of anti-diabetic drugs in a rural area of Tamilnadu, South India – Aprospective, observational study. Int J Pharm Biol Sci. 2013;4:514-9.
[36] Das P, Das BP, Rauniar GP, Roy RK, Sharma SK. Drug utilization pattern and effectiveness analysis in diabetes mellitus at a tertiary care centre in Eastern Nepal. Indian J Physiol Pharmacol. 2011;55:272-80.
[37] Sultana G, Kapur P, Aqil M, Alam MS, Pillai KK. Drug utilization of oral hypoglycemic agents in a university teaching hospital in india. J Clin Pharm Ther. 2010;35:267-77.
[38] Rajeshwari S, Adikhari P, Pai MR. Drug utilization study in geriatric type 2 diabetic patients. J Clin Diagn Res. 2007;1:440-3.
Cite This Article
  • APA Style

    Basim Audib Motar. (2017). Anti-diabetic Drugs Utilization in Type 2 Diabetic Patients in AL-Nasiriya Governorate / Iraq. American Journal of Internal Medicine, 5(6), 117-124. https://doi.org/10.11648/j.ajim.20170506.12

    Copy | Download

    ACS Style

    Basim Audib Motar. Anti-diabetic Drugs Utilization in Type 2 Diabetic Patients in AL-Nasiriya Governorate / Iraq. Am. J. Intern. Med. 2017, 5(6), 117-124. doi: 10.11648/j.ajim.20170506.12

    Copy | Download

    AMA Style

    Basim Audib Motar. Anti-diabetic Drugs Utilization in Type 2 Diabetic Patients in AL-Nasiriya Governorate / Iraq. Am J Intern Med. 2017;5(6):117-124. doi: 10.11648/j.ajim.20170506.12

    Copy | Download

  • @article{10.11648/j.ajim.20170506.12,
      author = {Basim Audib Motar},
      title = {Anti-diabetic Drugs Utilization in Type 2 Diabetic Patients in AL-Nasiriya Governorate / Iraq},
      journal = {American Journal of Internal Medicine},
      volume = {5},
      number = {6},
      pages = {117-124},
      doi = {10.11648/j.ajim.20170506.12},
      url = {https://doi.org/10.11648/j.ajim.20170506.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20170506.12},
      abstract = {To study the utilization pattern of anti-diabetic drugs in type 2 diabetic patients and to evaluate the association of diabetes with demographic details and it's metabolic control. The study was carried out on 100 type 2 diabetic patients who visited AL- Nasiriya center for diabetes and endocrinology. Demographic details and complete prescriptions drugs, FBS (fasting blood sugar), HbA1c and BMI (body mass index) were recorded. A total of 100 type 2 diabetic patients, 27(27%) were males and 73(73%) were females. The greatest number of patients, 43%, were in the age group of 51-60 years. Obesity (BMI ≥ 30) were found in 51% of patients especially females 45(61.3%). Poor glycemic control (HbA1c ≥ 9) were found in 65% of the patients. Oral anti-diabetic drugs were prescribed in 53%, 16(60%) were males and 37 (50.6%) were females. Biguanide (metformin) alone, 22%, was the most common anti-diabetic drugs prescribed. Biguanides (metformin) and sulfonylurea combination, 19%, was the commonest anti-diabetic drugs combination. Insulin preparations alone were used in 23% of the patients and Novomix was the commonest type (10%). We concluded that oral anti-diabetic drugs were the most common prescribing drugs. Metformin was the commonest prescribing anti-diabetic drugs. Metformin and sulfonylurea being the most frequent combination prescribed. There were increasing in the use on insulin preparations in the treatment of type 2 diabetic patients. In achieving optimal glycemic control, the efficacy of anti-diabetic drugs was only 10%, planning of more intensification anti-diabetic treatment is necessary.},
     year = {2017}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Anti-diabetic Drugs Utilization in Type 2 Diabetic Patients in AL-Nasiriya Governorate / Iraq
    AU  - Basim Audib Motar
    Y1  - 2017/11/10
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ajim.20170506.12
    DO  - 10.11648/j.ajim.20170506.12
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 117
    EP  - 124
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20170506.12
    AB  - To study the utilization pattern of anti-diabetic drugs in type 2 diabetic patients and to evaluate the association of diabetes with demographic details and it's metabolic control. The study was carried out on 100 type 2 diabetic patients who visited AL- Nasiriya center for diabetes and endocrinology. Demographic details and complete prescriptions drugs, FBS (fasting blood sugar), HbA1c and BMI (body mass index) were recorded. A total of 100 type 2 diabetic patients, 27(27%) were males and 73(73%) were females. The greatest number of patients, 43%, were in the age group of 51-60 years. Obesity (BMI ≥ 30) were found in 51% of patients especially females 45(61.3%). Poor glycemic control (HbA1c ≥ 9) were found in 65% of the patients. Oral anti-diabetic drugs were prescribed in 53%, 16(60%) were males and 37 (50.6%) were females. Biguanide (metformin) alone, 22%, was the most common anti-diabetic drugs prescribed. Biguanides (metformin) and sulfonylurea combination, 19%, was the commonest anti-diabetic drugs combination. Insulin preparations alone were used in 23% of the patients and Novomix was the commonest type (10%). We concluded that oral anti-diabetic drugs were the most common prescribing drugs. Metformin was the commonest prescribing anti-diabetic drugs. Metformin and sulfonylurea being the most frequent combination prescribed. There were increasing in the use on insulin preparations in the treatment of type 2 diabetic patients. In achieving optimal glycemic control, the efficacy of anti-diabetic drugs was only 10%, planning of more intensification anti-diabetic treatment is necessary.
    VL  - 5
    IS  - 6
    ER  - 

    Copy | Download

Author Information
  • Department of Internal Medicine, Thi-Qar University, Thi-Qar, Iraq

  • Sections