ASSESSMENT OF GLYCATED HEMOGLOBIN LEVEL AND PRESCRIBING PATTERN OF ORAL HYPOGLYCEMICS IN TYPE 2 DIABETES MELLITUS PATIENTS ADMITTED AT TERTIARY CARE HOSPITAL

Abstract

Background: Diabetes is a chronic condition associated with abnormally high levels of glucose in the blood. It may be due to impaired insulin secretion, resistance to peripheral actions of insulin, or both. Evaluating the managing strategies, including prescribing pattern of hypoglycemics is crucial for ensuring effective glycemic control, reducing complications, and optimizing patient outcomes. Glycated hemoglobin (HbA1c) is a key marker that indicates a person’s glycemic control over the past two to three months. Monitoring HbA1c levels provides insights into how well diabetes is managed and can guide adjustments in therapy to prevent complications.

Objectives: To assess the prescribing pattern of hypoglycemics, and also to evaluate the HbA1c level in T2DM patients admitted at tertiary care hospital.

Methodology: This was a prospective cross-sectional study on Type II diabetes mellitus (T2DM) patients admitted in the department of General Medicine at Siddaganga hospital, Tumkur. Ethical approval was obtained from SMCRI. A total of 117 cases were enrolled based on the inclusion criteria over a period of 6 months. Details such as demographics, personal history, past history, current lab investigations, medical condition and medication information were obtained using a pre-designed patient data collection form. The collected information was documented and subjected to appropriate statistical methods.

Results: Among the 117 cases, higher incidence of T2DM was found in males 67(57.3 %). The majority of the patients belong to the category of age between 50-59 and 60-69 years (28.2%). Dual-therapy was the most preferred therapy, used in 75 (64.1%) patients. The most prescribed oral hypoglycemic agent is Glimepiride +Metformin (65.1%). Biguanides were the most preferred class of drugs, accounting for 141 (53.5%) patients. Most of the diabetic patients were having poor control 21 (17.9%) as per HbA1c investigation. Our study results shows that HbA1c level is not having relationship with Oral Hypoglycemics by the chi-square test. T-test results were showed that there is a relationship between the before and after hospitalization in response to therapeutic effect for the p-value < 0.05. The major complication of T2DM was found to be Hypertension and affecting 20 (46%) patients.

Conclusion: Our study concludes that male patients have a higher incidence of T2DM. The majority of patients are receiving dual-therapy with the Glimepiride + Metformin combinations. Among Hypoglycemic medications, Biguanides are the most commonly preferred class of drugs, with Metformin being the most frequently used. T2DM patients are often associated with Hypertension. Most proportion of patients exhibited poor glycemic control as indicated by HbA1c level. Therefore, there is a need for clinical pharmacists to educate patients about lifestyle changes, improve medication adherence, optimize therapeutic outcomes and prevent complications.