Drug use evaluation in diabetic patients at out patient department Gorakhpur.
Diabetes Mellitus (DM) is characterized by abnormalities in the normal carbohydrate, fat, and protein metabolism. On the basis of the body response to insulin DM is mainly divided in two type's i.e Type-I DM and Type-II DM. Type-I is insulin dependent diabetes mellitus which involves damage of pancreatic 3 cells, while Type-II is non-insulin dependent diabetes mellitus which progress with the resistance to insulin. It is estimated that in India there are around 50.8 million in registered till year 2010 and this number may raise to 87.0 million by 2030 . Current estimates revealed that there are at least 150 million people living with diabetes worldwide of which two-third is from developing countries . The total number of diabetic patients is predicted to rise approx. 300 million by 2025 . Due to high blood sugar levels DM patients are more susceptible to a wide range of infectious bacterial and fungal infections . Diabetes treatment depends upon type and severity of diabetes. Treatment decisions are influenced by the age, life expectancy, comorbid conditions and severity of vascular complications.
The present study was conducted to establish the current prescribing pattern of antidiabetic drug in the area of Gorakhpur. Two hundred diabetic patients were the part of this study, of whom 125 (62.5%) were males and 75 (37.5%) females. Majority 44.5% of the patients were from the age group 40-50 years, followed by the age group 50-60 years (26.50%). About 53 (26.5 %) patients had no co-existing illness, while 47 (31.97%) patients had hypertension. Antidiabetic agents prescribed were second generation sulfonylurea, biguanides, thiazolidinediones and insulin. It was seen that 75 (37.5%) were on monotherapy and 125 (62.5%) were on polytherapy for diabetes. Out of 125 patients on polytherapy 89 (44.5%) were on a two drug combination, 35 (17.5%) on a three drug combination and 1 (0.5%) on four drug combination. In monotherapy insulin 31 (15.5%) was found maximum prescribed followed by thiazolidinediones 13 (6.5%), sulfonylurea 11 (5.5%), herbal 8 (4%), biguanides 7 (3.5%) and acarbose 5 (2.5%). Among antidiabetic drugs sulfonylurea (65%) and biguanides (65%) were most frequently prescribed followed by thiazolidinediones (23%) and alpha glucosidase inhibitors (3%).
The treatment pattern observed in this study were found in following order Biguanides= Sulfonylurea > Thiazolidinediones > Insulin > Herbal > Acarbose. Among the sulfonylurea category prescription was found to be maximum for glipizide followed by gliperamide. Among Biguanides only prescribed drug was metformin. Among thiazolidinediones category pioglitazone was maximum prescribed followed by rosiglitazone. There is a need to encourage physicians to follow the guidelines while treating diabetes. Overall there was no implementation of the clinical and therapeutic guideline for the management of DM which may be one of the potential reason for the current prescription pattern for the diabetic patients. Health regulatory authorities should take some initiatives to ensure the implementation of the therapeutic guidelines in all the health care settings through out India. Such initiatives will not only result in rational and quality use of medicine but also help in reducing the drug related problems with a higher therapeutic outcomes and better control for the conditions like diabetes mellitus.
Conflict of Interest
All the authors have no conflict of interest
Article Received on: 19th Nov, 2010
Revised on: 27th Nov, 2010
Approved for Publication: 9th Dec, 2010
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Tripathi Poonam, Pandey Awanish, Pandey Rishabh, Goswamy Shambaditya & Srivatava Rashmi
(1) Institute of Technology and Management, Gorakhpur, India
Institute of Technology and Management, AL-1 Sector-7 GIDA
Gorakhpur U.P 273209, India
Phone No: 09897696504,09670470766
Email: poonam firstname.lastname@example.org
TABLE 1: Anti-diabetic Drug Utilization (Individual\Combination) Anti-diabetic Mono- Combination Total drugs Therapy Sulfonylurea 11 119 130 (65%) Biguanide 7 123 130 (65%) Thiazolidinediones 13 43 56 (28%) Acarbose 5 1 6 (3%) Insulin 31 -- 31 (15.5%) Herbal 8 -- 8 (4%)
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|Title Annotation:||Short Communication|
|Author:||Poonam, Tripathi; Awanish, Pandey; Rishabh, Pandey; Shambaditya, Goswamy; Rashmi, Srivatava|
|Publication:||Archives of Pharmacy Practice|
|Date:||Jul 1, 2010|
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