Zahra Ali, Sardar Fakhar Imam, Muhammad Adnan, Iffat Shabbir, Tayyaba Rahat.
Prescription pattern of antidiabetic drugs among type 2 diabetes patients of Sir Ganga Ram Hospital, Lahore.
Pak J Med Res Jan ;54(3):94-5.

The study was designed to observe the current status of anti-diabetic drugs prescription pattern. Patients, Methods and Results: The case series prospective study was carried out at Diabetes Clinic of Sir Ganga Ram Hospital, Lahore. Two hundred known type 2 diabetics, age more than 18 years, of both genders, using anti-diabetic drugs at least for last one month were included in the study. Study duration was three months (Jan-Mar 2014). An interview was conducted to collect demographic and clinical information of the patients. The demographic details included age, gender, socio-economic status and education. Clinical and biochemical data included random plasma glucose level, duration of diabetes, family history of diabetes, co-morbidities and antidiabetic drugs prescribed. Data analysis was performed by using Statistical Package for Social Sciences (SPSS) version 21. Categorical variables were presented as number (percentage) and numerical variables in mean (standard deviation). Mean age of the patients and male-to-female ratio was 53±9 years and 1:2, respectively. Mean for plasma glucose level was 244±93 mg/dl. Patients who reported family history of diabetes were 127(63.5%). Mean duration of diabetes was 7.2±5.7 years. Patients using insulin had mean duration of diabetes 9.3±5.7 years; and on two drugs combination had 7.6±5.7 years. Socioeconomic status showed that majority of patients 163(81.5%) were from poor class and 37(18.5%) from middle class. None of them was from upper class. There was no significant difference (p > 0.05) present between poor and middle class regarding prescribed medicines or type of treatment. It was observed that only 78% patients were attending the diabetes clinic regularly, while 22% patients were visiting healthcare facility occasionally; and were not taking antidiabetic drugs regularly. History of hypertension (HTN) was reported by 76.5% patients; ischemic heart disease (IHD) 21.5% patients; lipid abnormalities 19.0% patients; diabetic nephropathy (DN) 8.5% patients; and diabetic retinopathy (DR) 8.0%. No significant difference (p > 0.05) was present between the comorbidity (HTN, dyslipidemia, DN and DR) and antidiabetic drug prescription. Patients who had history of IHD (53.5%) were on Insulin; contrary to this 22.2% patients without IHD were also on Insulin. Therefore significant association was found between IHD and Insulin prescription (p 0.002). The frequency for users of mono antidiabetic drug was 130 (65%) patients; and for combination antidiabetic drug was 70 (35%) patients. Metformin was the leading drug which was prescribed in total of 109 (54.5%) patients; as monotherapy to 47 (23.5%) patients; and as combination therapy to 47 (23%) patients. Insulin prescription to 39 (19.5%) patients was second highest as monodrug; followed by Sulphonylurea to 34 (17.0%) patients. However, as combination, Sulphonylurea prescription was greater than Insulin. Combination of metformin and sulphonylurea as two drugs was more prescribed to 37 (18.5%) patients than as fixed dose to 11 (5.5%) patients. Combination of metformin and insulin was prescribed to 10 (5.0%) patients. Among sulphonylurea, Glimepiride was more prescribed (23.5%), than Glibenclamide (17.5%) and Gliclazide (4%). Among Glitazone, commonly prescribed drug was Pioglitazone (4.5%) followed by Roziglitazone (0.5%). As two drugs combination, Metformin plus Sulphonylurea was most frequently prescribed combination followed by Metformin plus Insulin.

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