Assessment of Antihypertensives Drug Class in Type 2 Diabetes and It’s Complications (original) (raw)
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Panacea Journal of Medical Sciences, 2020
Background: Hypertension and Type 2 diabetes are the two factors having a great impact on the mortality and morbidity of a substantial amount of population over the globe. It has also been identified that Hypertension and Type 2 diabetes co-exist in the majority of the patients. There is a wide range of antihypertensive drugs available for the management of hypertension namely, enzyme inhibitors (ACEIs), diuretics (D), beta-blockers (β Bs), calcium-channel blockers (CCBs), and angiotensin receptor blockers (ARBs). Aim: To study the Efficacy and tolerability of antihypertensive drugs in Diabetic and Non-Diabetic patients at a tertiary care centre in Ganjam, Odisha Materials and Methods: A prospective study with 400 patients was conducted in which 200 were included in the non-diabetic group, and 200 were included in the diabetic group. The study period was six months, from June 2019 to November 2019, and it was conducted at the MKCG Medical College Berhampur, Ganjam Odisha. Patients with Type 1 diabetes were excluded from the study. All the patients suffering from mild and moderate hypertension were included in the study. Also, the patients with and without type 2 diabetes were included in the study. Results: Fifty of the non-diabetics with hypertension belonged to 51-70 years of age group. Similarly, 52.5% of the patient in the Diabetics with Hypertension group belonged to 51-70 years. There was no statistically significant difference among the different mean values among the diabetic and non-diabetic patients except the mean values of diabetic and non-diabetic patients under AST when given ßB + CCB + D + ACEI. There was no statistically significant difference among the renal function of various drugs among the diabetic and non-diabetic group. More people were given two drugs combination as compared to monotherapy, three drugs combination and four drugs combination. There was no statistically significant difference among the various drug combinations on the systolic blood pressure. It was identified various mean urea, mean creatinine and mean uric acid values for different drug combinations. There was no statistically significant difference among the renal function of various drugs among the diabetic and nondiabetic group. Conclusion: The study concluded that antihypertensive drugs were significantly helpful in treating systolic blood pressure. The BP was controlled substantially in the diabetics and non-diabetics using the ACEI drug.
A study on drug utilization pattern of antihypertensive drugs in hypertensive diabetic patients
International Journal of Basic & Clinical Pharmacology
Background: Hypertension management is of paramount importance in diabetic patients for reduction of cardiovascular and other complications. The objective of the present study was to assess prescribing pattern of antihypertensive drugs in hypertensive type 2 diabetic patients and evaluate them by comparing with Eighth Joint National Committee (JNC-8) hypertension treatment guidelines.Methods: A prospective observational study was carried out on 110 hypertensive type 2 diabetic patients of age 41-80 years visiting outpatient department of Medicine at G.S. Medical College and Hospital, UP, India for 4 months. JNC-8 hypertension management guideline was considered while evaluating the prescribed drugs. All the relevant data was collected from the prescription card of the patient on a preformed performa and analyzed using descriptive statistics.Results: Total of 176 drugs was prescribed to the study patients among which two drug combination therapy (55.45%) was mostly used. The most com...
Prescription Pattern of Antihypertensive Drugs for HypertensivePatients with Type-2 Diabetes
Background: It is said that, people with both diabetes and hypertension have approximately twice the risk of cardiovascular disease as non-diabetic people with hypertension. Hypertensive diabetic patients are also at increased risk for diabetes-specific complications including retinopathy and nephropathy.Prescription pattern is one of the indicators of the current situation of a specific patient community or group. Aim of the study: The aim of this study was to assess theprescription pattern of antihypertensive drugs for hypertensive patients with type-2 diabetes. Methods: This was an observational cross sectional study and it was conducted in Dhaka Medical College Hospital and BIRDEM Hospital during the period from July2016 to June 2017. In total 140 diagnosed hypertensive patients with type 2diabetes mellitus attending to the Endocrine Departments of Dhaka Medical College Hospital and BIRDEM Hospital completed the full tenure of the study were finalized as the study population.After data analysis, results were find out according to the objectives, study result were presented in the form of tables, charts and description of the key findings according to need. The collected data were also be entered and analyzed using statistical software SPSS version 16. Result: In this study commonly used antihypertensive drugs were ARBs, CCBs, diuretics, Beta-Blockers and ACEIs and that were used in 31%, 24%, 19%, 18% and 8% patients respectively. In total 66 (47.1%) patients taken single drug and 74 (52.9%) patients taken combination drugs. In total 73%, 23% and 4% patients taken double, triple and quadruple combination of antihypertensive drugs respectively. As monotherapy, ARBs, CCBs, ACEIs, Beta Blockers, and diuretics were used in 35%, 23%, 20%, 16% and 6% patients respectively. In DMCH, ARB + Diuretics (8) and ARB +CCB (8) were most commonly used combinations. In 11.40% cases injectable drugs were used whereas in 88.80% cases no injectable drug had been used. In this study in most of the cases (71%) drugs from Essential Drug List of Bangladesh had been used. Conclusion: There was higher use of ARB and less use of diuretics in our study. Still there is room for better control of hypertension and optimization of antihypertensive therapy. In spite of these data and published guidelines, inconsistencies exist towards treatment approach, because of which physicians sometimes have to individualize the therapy, based on specific patient characteristics and response to treatment.
International Journal Of Community Medicine And Public Health
Background: Chronic hyperglycemia of diabetes mellitus (DM) is associated with long-term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels. We aimed to evaluate the prescribing pattern of antidiabetic drugs among Type 2 DM (T2DM) outpatients in Medical College, Kolkata.Methods: A cross sectional study was conducted over a period of three months in the Department of Pharmacology and Department of Endocrinology, Medical College, Kolkata. Detailed information of the participants regarding demography, medical history, duration of diabetes, family history of diabetes, prescribed antidiabetic medicines, comorbid conditions and associated medications were evaluated.Results: A total of 305 subjects with T2DM were included and 516 prescriptions were analyzed. 57% of the subjects were male. Majority of patients the were in the age group of 51-60 (37.7%) years. Most of them had history of diabetes between 1-5 years (46.26%) and mos...
International Journal of Basic & Clinical Pharmacology
Background: Type 2 diabetes mellitus (T2DM) is a leading cause of significant morbidity and mortality in developing countries. Evaluation of anti-diabetic drug use pattern guides the healthcare professionals to identify early signals of irrational prescribing and to plan interventions to optimize the benefits of pharmacotherapy.Methods: Observational descriptive study was conducted on 500 prescriptions of T2DM patients collected from Outpatient department of a tertiary care hospital. Prescriptions were analysed for type, number, generic/brand names, fixed dose combinations (FDCs) of anti-diabetic drugs and anti-diabetic drugs prescribed from within National List of Essential Medicines (NLEM) 2015.Results: Average number of anti-diabetic drugs per prescription was 2.5. Of these 49% were from within NLEM and only 39% were prescribed by their generic names. Among all the anti-diabetic groups of drugs used, biguanide (32.85%) was the most frequently prescribed followed by insulins (25.4...
2015
Recent Study in the tertiary hospital in North India showed that Prevalence of Diabetes Mellitus Type-2 is on the increase. To Evaluate the Utilization of Oral hypoglycaemic drugs in Diabetic Type-2, the study was conducted on Patients with established type 2 diabetes (n=360) visiting Out Patient Department. Patients were interviewed and the data obtained was tabulated in Microsoft Excel. In the present study the maximum number of patients suffering from Type 2 DM (51.2%) were males, from age group of 51-60 years. The prevalence of co-morbidities in Diabetic Patients Suffering from Hypertension was 30.56%. Sulphonylureas were the most prescribed oral Hypoglycaemics in 53.2% patients and the combination of Sulphonylureas and Biguanides was most prescribed combination in 33.3% patients. Cardiovascular drugs were the second most prescribed class 49.5% in hypertensive patients. During study, 3.6% were Average drugs prescribed, 72.5% were generic prescription, 98.6% drugs were from National Essential Drug list, 1.7% were antibiotics and 7.9% were Injections. Our study showed that the approach of treatment is initiation of therapy with lifestyle modifications followed by oral anti diabetics or their combinations. It is suggested that Self Monitoring of Blood Glucose (SMBG) should be promoted in Indian diabetic patients for glycemic control.
Use of Antihypertensive Medications in Patients with type -2 Diabetes in Ajman, UAE
Acta medica Iranica, 2015
Optimal reduction in blood pressure with antihypertensive agents helps to prevent microvascular and macrovascular complications of diabetes. The objective of the study was to evaluate the current utilization pattern of antihypertensive medications among patients with diabetes and coexistent hypertension as per the JNC seventh report guidelines. A Cross-sectional survey was conducted among patients with diabetes attending outpatient department of Internal Medicine at a hospital at Ajman. Medical records of patients were used to obtain diagnostic, demographic and drug use information. Univariate analysis was performed using Chi-square and t- test followed by logistic regression to compute independent predictors. Of 132 patients with diabetes, uncomplicated hypertension (HTN) was coexistent in 81% (107/132) of patients. Males constituted 49.5% (53/107) of the total. Mean (SD) age of patients with HTN was 55.1(10.1) years higher than those without HTN 49.6 (9.9) years (P<0.01). Highe...
Utilization of Antihypertensive Drugs in Diabetic Patients in Sultan Qaboos University Hospital
Biomedical Journal of Scientific & Technical Research, 2021
Hypertension is very common among patients with diabetes. Approximately, 10 to 30% of type 1 and 60% of type 2 diabetic patients have hypertension. The patterns of utilization of antihypertensive drugs in diabetic patients were studied retrospectively in 101 hypertensive diabetic patients. Study findings focused on showing if there is any reason behind the differences. This study helps to implement interventions aimed at improving antihypertensive drug utilization and reducing medication errors. Drug factors such as dosage form, average daily dose, and adverse drug reactions were assessed. 53.5% of patients were on angiotensin II receptor blockers. 59.4% of the patients were on multiple drug therapy. Average daily dosages were almost comparable with the American Society of Hypertension and the International Society of Hypertension guidelines. Patients in the age group (≥ 60) used β-blockers with a higher percentage than patients of the age group (18-59). Vasodilators, calcium channel blockers, and β-blockers showed higher use percentages in patients with diabetic nephropathy compared to patients with no nephropathy whereas the percentage of angiotensin-converting-enzyme inhibitors was higher in no nephropathy status. 84.2% of patients had uncontrolled systolic blood pressure, and 43.6% of patients had uncontrolled diastolic blood pressure.
Background: India has a sizeable Diabetic Population with more than 72 million type-2 diabetic patients. Glycemic control remains the major goal for prevention of complications arising from diabetes. Poor glycemic control can be prevented by using rational & safe use of anti-diabetic drugs. The study of the prescription pattern can be used to evaluate the Rational use of the drugs in diabetic patients. Methodology: A cross-sectional questionnaire-based study was carried out in 160 Diabetic patients attending diabetic OPD of a public tertiary care hospital to assess their prescribing pattern of anti-diabetic drugs.