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Jha H, Khan TA, Khan N, Fatima G. Analysis of Prescription Pattern of Anti-diabetic Medications in a Teaching Hospital in North India. Cureus 2024; 16:e63343. [PMID: 39070354 PMCID: PMC11283627 DOI: 10.7759/cureus.63343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2024] [Indexed: 07/30/2024] Open
Abstract
PURPOSE This retrospective observational study aimed to comprehensively analyse the clinical profile and treatment modalities of patients diagnosed with type 2 diabetes mellitus (T2DM) who were treated at a tertiary care centre. METHODS The study included a cohort of 300 individuals who sought medical care at the hospital from January 2023 to January 2024. The analysis primarily examined parameters such as the mean number of anti-diabetic medications per prescription, the proportion of various categories of anti-diabetic medications prescribed, the predominant class and type of anti-diabetic medications prescribed, and the proportion of anti-diabetic medications prescribed from the essential drug lists. RESULTS The age distribution demonstrated that 52.0% of participants were above 60 years old, showcasing a substantial elderly representation. Gender distribution emphasized a male predominance at 65.0%, highlighting potential gender-specific implications in type II diabetes. The blood profile analysis of patients with T2DM revealed a range of values for key parameters. Fasting blood glucose levels ranged from a minimum of 101 mg/dL to a maximum of 359 mg/dL, with a mean of 180.01 mg/dl. The comprehensive analysis of anti-diabetic drug utilization, based on the total number of units prescribed, sheds light on the diverse treatment approaches employed for managing diabetes mellitus (DM). Insulin, comprising 31.3% of the total units, plays a pivotal role in glycemic control, with both regular and biphasic formulations contributing significantly at 26.3% and 9.3%, respectively. Among the 300 patients, the overall utilization of anti-diabetic drugs reveals that 38.7% of individuals are using a combination of insulin with oral anti-diabetic drugs, while 61.3% are relying on oral anti-diabetic drugs alone. The most frequently prescribed drug combinations for diabetes management include sulphonylurea with biguanides, emerging as the most prevalent combination with 22 occurrences. CONCLUSION The study's findings contribute valuable insights into the socio-demographic profiles and anti-diabetic drug utilization patterns among diabetes patients.
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Affiliation(s)
- Hemali Jha
- Internal Medicine, Integral Institute of Medical Sciences and Research Centre, Lucknow, IND
| | - Tauseef Ahmad Khan
- Internal Medicine, Integral Institute of Medical Sciences and Research Centre, Lucknow, IND
| | - Nida Khan
- Internal Medicine, Integral Institute of Medical Sciences and Research Centre, Lucknow, IND
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Sapkota B, Bokati P, Dangal S, Aryal P, Shrestha S. Initiation of the pharmacist-delivered antidiabetic medication therapy management services in a tertiary care hospital in Nepal. Medicine (Baltimore) 2022; 101:e29192. [PMID: 35482989 PMCID: PMC9276257 DOI: 10.1097/md.0000000000029192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/09/2022] [Indexed: 01/04/2023] Open
Abstract
The medication therapy management (MTM) pharmacists follow the philosophy of pharmaceutical care to address individualistic medication therapy requirements in their practice settings.The present study aimed to introduce the pharmacist-delivered MTM services among type 2 diabetes mellitus patients at a tertiary care hospital in Nepal.Cross-sectional study was conducted at Patan Hospital, Lalitpur, Nepal, among 200 patients with type 2 diabetes mellitus from July to December 2019. The intervention included maintenance of medication profile for individual patients, and then MTM service was proposed based on 5 core elements of MTM services proposed by the American Pharmacists Association. Both antidiabetic and non-antidiabetic medicines were coded as per the anatomic, therapeutic, and chemical classification and defined daily dose assignment 2020 for documentation. The Charlson Comorbidity Index was used to index comorbidities. The drug interaction profile was checked with the Medscape Drug Interaction Checker.Both fasting and postprandial blood sugar levels were significantly associated with age (P-values <.000 for both), baseline symptom (P-values .012 and .003 respectively), and diet plan proposed (P-values .049 and .011 respectively). Maximum cases of drug interactions requiring close monitoring were between metformin and insulin regular (i.e., 11, 5.5%).This was a novel initiative of the MTM services in a resource constraint country like Nepal and can show a clue for the pharmacists targeting such services in other similar settings.
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Affiliation(s)
- Binaya Sapkota
- Nobel College Faculty of Health Sciences, Sinamangal, Kathmandu, Nepal
| | - Priyanka Bokati
- Nobel College Faculty of Health Sciences, Sinamangal, Kathmandu, Nepal
| | - Salina Dangal
- Nobel College Faculty of Health Sciences, Sinamangal, Kathmandu, Nepal
| | - Pooja Aryal
- Nobel College Faculty of Health Sciences, Sinamangal, Kathmandu, Nepal
| | - Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
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Saboo B, Agarwal S, Gupta S, Makkar B, Panneerselvam A, Sahoo AK, Ramchandani GD, Das S, Erande S, Kadam Y, Abhyankar MV, Revankar S. REAL-world evidence of risk factors and comorbidities in YOUNG Indian adults with type 2 diabetes mellitus: A REAL YOUNG (diabetes) study. J Family Med Prim Care 2021; 10:3444-3452. [PMID: 34760771 PMCID: PMC8565132 DOI: 10.4103/jfmpc.jfmpc_2010_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 03/01/2021] [Indexed: 11/04/2022] Open
Abstract
Objective To assess the clinical characteristics, risk factors, and comorbidities associated with type 2 diabetes mellitus (T2DM) in young adult patients. Methods This is a retrospective, multicentric real-world study that included young adults (18-45 years) with T2DM. Primary information including demographics, medical and family history, biochemical measures (pre-and post-prandial blood glucose levels, glycosylated hemoglobin [HbA1c] and blood pressure, and lipid parameters) smoking and drinking habits were collected retrospectively from the medical records of the respective hospitals/clinics. Data were analyzed using descriptive and appropriate comparative statistics. Results A total of 22,921 patients from 623 sites were included. The median age was 37.0 years and the majority were men (61.6%). The proportion of patients from the age group >35-≤45 years was 62.7%. Among all patients, 46.9% had only T2DM; however, 53.1% of patients had T2DM with other comorbidities (T2DM with hypertension, dyslipidemia, and both). The majority of patients had elevated body mass index (BMI) (overweight, 46.6%; and obese, 22.9%). Family history of T2DM (68.1%) was most common in overall population. Sedentary lifestyle (63.1%), alcohol consumption (38.9%), and regular smoking (23.1%) were the most common associations in patients with T2DM with dyslipidemia and hypertension. Uncontrolled HbA1c level (≥7%) were observed in 79.2% of patients. The level of HbA1c was significantly increased with the duration of T2DM and sedentary lifestyle (p < 0.001). Conclusion Higher BMI, family history of T2DM, sedentary lifestyle, alcohol consumption, and smoking were the most common risk facors, while hypertension and dyslipidemia were the most prevalent comorbidities associated with T2DM in young Indian adults.
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Affiliation(s)
- Banshi Saboo
- Department of Diabetology, Diabetes Care and Hormone Clinic, Ambawadi, Ahmedabad, Gujarat, India
| | - Sanjay Agarwal
- Department of Internal Medicine, Dr. Sanjay Agarwal's Aegle Clinic, City, Pune, Maharashtra, India
| | - Sunil Gupta
- Department of Diabetology, Sunil's Diabetes Care Research Centre, Nagpur, Maharashtra, India
| | - Brij Makkar
- Department of Diabetology, Dr. Makkar's Diabetes and Obesity Centre, Delhi, India
| | - A Panneerselvam
- Department of Diabetology, Aruna Diabetes Centre, Chennai, Tamil Nadu, India
| | - Abhay Kumar Sahoo
- Department of Endocrinology, IMS and SUM Hospital, Bhubaneshwar, Odisha, India
| | - G D Ramchandani
- Ramachandani Diabetes Care and Research Centre, Kota, Rajasthan, India
| | - Sambit Das
- Department of Endocrinology, Endeavour Clinics, Bhubaneswar, Odisha, India
| | - Suhas Erande
- Department of Diabetology, Akshay Hospital and Diabetic Speciality Centre and Insulin Pump Centre, Pune, Maharashtra, India
| | - Yogesh Kadam
- Department of Diabetology, Poona Diabetes Centre, Pune, Maharashtra, India
| | - Mahesh V Abhyankar
- Department of Scientific Services, Scientific Services, USV Private Limited, Mumbai, Maharashtra, India
| | - Santosh Revankar
- Department of Scientific Services, Scientific Services, USV Private Limited, Mumbai, Maharashtra, India
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Patil S, Patil Y, Patil SK. Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study. ITALIAN JOURNAL OF MEDICINE 2021. [DOI: 10.4081/itjm.2021.1444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.
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An investigation to determine the association of burning mouth syndrome-like symptoms with diabetic peripheral neuropathy in patients with type II diabetes. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2021. [DOI: 10.1016/j.ajoms.2020.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Upadhyay TR, Kothari N, Shah H. Association Between Serum B12 and Serum Homocysteine Levels in Diabetic Patients on Metformin. J Clin Diagn Res 2016; 10:BC01-4. [PMID: 27190787 DOI: 10.7860/jcdr/2016/17604.7518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/08/2016] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Type-2 Diabetes Mellitus (T2DM) and metformin both can lower serum B12 (s.B12). Raised serum Homocysteine (s.Hcy) is considered as an early marker of B12 deficiency. AIM The study aimed to check whether homocysteine levels are more sensitive indicator of s. B12 deficiency or not among diabetics using metformin. MATERIALS AND METHODS Mean s.B12 and s.Hcy levels of 30 cases (diabetics on metformin <5years) were compared with 30 diabetic controls not on metformin and 31 nondiabetic controls and statistically analysed by ANOVA and post-hoc tests. RESULTS No significant differences in either s.B12 mean or s.Hcy mean were found between cases and diabetic controls. s.B12 mean did not differ significantly but s.Hcy mean was significantly higher among nondiabetics as compared to diabetic control. s. B12 level of Nondiabetic group was in borderline category while mean s. B12 levels of cases and diabetic control groups was in normal category but nearer to the lower cut off. Mean s.Hcy values in all the groups were high. Pearson correlation showed strong association between s.B12 and s.Hcy in all the groups. Additionally equation based on linear regression was derived to calculate either of the s.B12 or s.Hcy. On Receiver Operative Characteristic (ROC) curve, area under curve value was 0.842 for the value of s.Hcy. CONCLUSION In this study neither metformin nor T2DM could be identified as a cause for s.B12 lowering and raised s.Hcy in the scenario of low normal levels of s.B12 (<300pmol/L). If B12 deficiency recognized early using s. Hcy, consequences due to B12 deficiency can be prevented or delayed among nondiabetics as well as among diabetics and metformin users.
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Affiliation(s)
- Twinkal R Upadhyay
- Resident, Department of Biochemistry, H.M. Patel Centre for Medical Care and Education, Pamukh Swami Medical College and Shree Krishna Hospital , Karamsad, Gujarat, India
| | - Nitin Kothari
- Assistant Professor, Department of Pharmacology, Pacific Medical College and Hospital , Udaipur, Rajasthan, India
| | - Hitesh Shah
- Professor, Department of Biochemistry, H.M. Patel Centre for Medical Care and Education, Pamukh Swami Medical College and Shree Krishna Hospital , Karamsad, Gujarat, India
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Gupta M, Iqbal A, Nair S, Varma M, Vidyasagar S. Parental transmission of type 2 diabetes mellitus among patients attending a tertiary care hospital. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2015. [DOI: 10.1016/j.cegh.2015.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abraham AM, Sudhir PM, Philip M, Bantwal G. Illness perceptions and perceived barriers to self-care in patients with type 2 diabetes mellitus: an exploratory study from India. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-014-0266-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Baruah MP, Pathak A, Kalra S, Das AK, Zargar AH, Bajaj S, Unnikrishnan AG, Sahay RK. A revisit to prevailing care and challenges of managing diabetes in India: Focus on regional disparities. Indian J Endocrinol Metab 2014; 18:254-263. [PMID: 24944916 PMCID: PMC4056120 DOI: 10.4103/2230-8210.131113] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
An unprecedented rise in diabetes mellitus (DM) prevalence in India is the outcome of lifestyle changes in the background of genetic predisposition. Moreover, there are substantial regional variations in diabetes prevalence and management. The highest prevalence of DM was observed in southern region (Ernakulum, Kerala) and lowest prevalence was observed in North Eastern region (Manipur). Similarly large variations have been evident in overall awareness and diabetes care across the geographies within India. The regional challenges are largely affected by poor disease awareness, socioeconomic disparity and underutilization of the public health-care services. Though government has taken initiatives to address this issue, overall situation demands a collaborative effort from patients, health care professionals and the state. An exhaustive literature search was performed for articles and studies published on electronic databases. Present article assesses the regional disparity of diabetes epidemiology, current management practices and government policies for T2DM in India, identifies policy and research gaps, and suggests corrective measures to address the lacunae in diabetes care.
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Affiliation(s)
- Manash P. Baruah
- Director and Consultant Endocrinologist, Excel Center, Guwahati, India
| | - Ankit Pathak
- CEO, Worksure MedPharma Consultancy India Pvt. Ltd., New Delhi, India
| | - Sanjay Kalra
- Consultant Endocrinologist, Bharti Hospital and BRIDE, Karnal, Haryana, India
| | - Ashok K. Das
- Senior Professor of Medicine and Head of Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Abdul H. Zargar
- Medical Director, Center for Diabetes and Endocrine Care, Srinagar, Jammu and Kashmir, India
| | - Sarita Bajaj
- Department of Medicine Moti Lal Nehru Medical College Medical College, Allahabad, Uttar Pradesh, India
| | | | - Rakesh K. Sahay
- Professor, Department of Endocrinology, Osmania Medical College, Hyderabad, Andhra Pradesh, India
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Patel B, Oza B, Patel K, Malhotra S, Patel V. Health related quality of life in type-2 diabetic patients in Western India using World Health Organization Quality of Life – BREF and appraisal of diabetes scale. Int J Diabetes Dev Ctries 2013. [DOI: 10.1007/s13410-013-0162-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Patel M, Patel IM, Patel YM, Rathi SK. Factors associated with consumption of diabetic diet among type 2 diabetic subjects from Ahmedabad, Western India. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2012; 30:447-55. [PMID: 23304911 PMCID: PMC3763616 DOI: 10.3329/jhpn.v30i4.13328] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This cross-sectional study assessed the current situation of and factors associated with consumption of diabetic diet among 399 type 2 diabetes mellitus (T2DM) subjects from Ahmedabad, Western India. The study was performed with diagnosed (at least one year old) diabetic subjects who attended the Department of Diabetology, All India Institute of Diabetes and Research and Yash Diabetes Specialties Centre (Swasthya Hospital), Ahmedabad during July 2010-November 2010. The subjects completed an interviewer-administered questionnaire. The questionnaire included variables, such as sociodemographic factors, family history of diabetes, behavioural profile, risk profile (glycaemic status, hypertension, and obesity), and diet-related history (consumption of diabetic diet, consumption of low fat/skimmed milk, method of cooking, and sources for diet advice). Blood pressure, body mass index, glycosylated haemoglobin (HbA1c) level, and fasting lipid profile were measured. All analyses including multivariate logistic regression were conducted using SPSS, version 11.5. In total, 399 T2DM subjects (65% male, 35% female) with mean age of 53.16 +/- 7.95 years were studied. Although 73% of T2DM subjects were consuming diabetic diet, the good glycaemic control (HbA1c level < 7%) was achieved only in 35% of the subjects. The majority (75%) of the subjects had a positive family history of diabetes, and 52% were obese. In 77%, the main source of dietary advice was doctor. In 36%, the main methods of cooking were: boiling and roasting. The final multivariate model showed that visit to dietician, level of education, intake of low fat, and family history of diabetes were independent predictors for diabetic diet consumption among T2DM subjects. However, longitudinal and cohort studies are required to establish the association between consumption of diabetic diet and glycaemic control.
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Affiliation(s)
- Mayur Patel
- Swasthya Hospital, All India Institute of Diabetes and Research, Narainpura, Ahmedabad 380013, Gujarat, India
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