A cross-sectional study on prescribing pattern analysis of antidiabetic drugs in diabetes mellitus and its associated co-morbidities in tertiary care hospital

Importance: Diabetes is defined as a heterogeneous metabolic disorder characterized by chronic hyperglycemia and disruptions in carbohydrate, fat, and protein metabolism
Objective: To analyze the patterns of use of major pharmaceutical drug classes given for diabetes and comorbidities. To determine the which age group and gender are more prone to diabetes mellitus.
To identify and analyze the prescriptions with multiple drug therapy. To determine the signs and symptoms, risk factors, life style modifications, complications & co-morbidities in patients with diabetes mellitus. To provide patient counselling regarding life style changes in diabetes mellitus.
Design and Settings: It is prospective, observational study conducted on 100 patients in endocrinology Department at Prathima Institute of Medical Sciences. In this study, we analyzed the prescription pattern of anti-diabetic drugs, insulin treatment and its combination therapy in patients with Diabetes mellitus with or without comorbidities in a tertiary care hospital.
Participants: Study population: 100.Study Criteria; Inclusion criteria include: Adults of age group above 20 years of both sexes with Dm. Exclusion criteria includes: Pediatrics, Pregnant women.
Results: The present study included a total of about 100 patients out of which were 72 males and 28 were females. Maximum numbers of patients were found to be from 50-60 years of age, which contributed to 30% of the total sample size. 68% of the patients are mostly prescribed with class biguanides(metformin),11 % with class insulin and less prescribed were Thiazolidinediones (pioglitazone) 2% of whole. 48% of the patients are mostly prescribed combination therapy with class biguanides + sulfonyl urease (metformin + Glimepiride), 21 % with Biguanides+Dpp4 inhibitors (Metformin + sitagliptin) and less prescribed were Biguanides+ sulfonyl urease+SGLT2(metformin + Glimepiride + Dapagliflozin) with 3% of whole. 95 (75%) of the patients are prescribed monotherapy ,27(21%) with 2 drug therapy and 5(4%) with 3 drug therapy of the whole.
Hypertension was the common co-morbidity followed by CAD. DM+ HTN (52%), DM + CAD (10%), DM+CVA (5%), DM + others (7%) and DM without comorbidities (26%).40%,38%,12%,10% were under weight, normal weight, over weight and obese respectively. 53% were hypertensive and 47% were Non – hypertensive. 96 patients with medication adherence and 4 were neglecting. 46%,20%,15%,11%,1% were alcoholic, smokers, tobacco chewers, smokers + alcoholic, smokers + alcoholic + tobacco chewer respectively. However, 7% of the sample were neither alcoholic, smoking nor    tobacco chewers. 80 (80%) of patients had No form of physical activity, 14(14%) were doing regular
exercise. 68% were consuming rice and chapati, 23% were consuming only rice, 68% were inadequate sleep, 30%were normal sleep, 30% were decreased Appetite, 53% were increased appetite, 26% were Less thirst, 60% were more thirst. The prescribed therapeutic class of drugs for co-morbidities among  patients were ARB'S-Telmisartan in 17 number of patients, Beta blockers-Carvedilol in 27 number of patients, CCB'S- amlodipine in 16 number of patients, HMG-COA reductase-Atorvastatin in 26 number of patients, Diuretics-Hydrochlorothiazide, spironolactone in 18 number of patients, Vasodilators-Nitro glycerin in 8 number of patients, Antiplatelets-clopidogrel, Aspirin in  29 number of patients, Anticoagulants-Warfarin in 4 number of patients, Anticonvulsants-Gabapentin in 10 number of patients, Antidepressants- Nortriptyline in 3 number of patients, combinations -Telmisartan + Amlodipine in 7 number of patients, others - vitamins, antibiotics, PPI in 37 number of patients.
Conclusion: According to the findings of our study, there is a greater need for patient education about Diabetes mellitus in order to improve patient outcomes, identify and prevent complications, and provide knowledge about medication adherence. The current study sought to examine the prescription patterns of diabetic patients with or without comorbidity, with the specific goal of determining the current trend of anti-diabetic drug. According to observed social habits, diabetic patients’ lifestyles must change. The study's other goal was to implement a patient education program and treat co-morbidities among type 2 diabetes patients. Hypertension was the most common co-morbidity in our study, followed by CAD.