E-ISSN 2231-3206 | ISSN 2320-4672
 

Original Research 


Utilization of some newer oral antidiabetic agents in a tertiary care hospital

Darshan J Dave, R K Dikshit, Anuradha M Gandhi.

Cited by (2)

Abstract
Background: Type 2 diabetes mellitus (DM), a common metabolic disorder, prevalence of which is predicted to rise in virtually every country with the greatest increase expected in developing countries. Modification in diet and life style are usually insufficient to provide good, long-term metabolic control of type 2 DM; pharmacological adjuvants are required in majority of patients. As there is no recommended regimen, it is difficult to choose an antidiabetic agent from the available groups which become even more complex by rapidly introducing newer agents.

Aims & Objective: To evaluate prescribing pattern of newer oral antidiabetic agents in a tertiary care hospital.

Materials and Methods: Prospective observational study was conducted for one year in the diabetic out patient department (OPD) at Civil Hospital, Ahmedabad. A total 290 randomly selected patients of all age groups and either sex of type 2 diabetes mellitus were observed and details were recorded in a predesigned case record form. FBS level of 120mg% and PPBS level of 150 mg% was considered for achieving satisfactory blood sugar control.

Results: Among the patients who had undergone blood sugar analysis at the time of study, FBS level was 120 mg% in 48 (22.42%) patients while PPBS level was 150mg% in 21 patients (9.81%) only. Oral antidiabetic drugs alone were prescribed in 242 (83.45%) patients while insulin was added along with oral antidiabetic agents in rest of patients. Among patients receiving oral antidiabetic drugs, monotherapy was prescribed in only 43 (14.83%) patients while in the rest of the patients combination therapy was prescribed. Among oral antidiabetic combination, glipizide along with metformin is the most commonly prescribed combination in 112 (38.42%) patients. Among newer agents, pioglitazone was the most commonly prescribed agent but only in combination with other oral antidiabetic agents.Pioglitazone was prescribed with glipizide and metformin in 44 (15.17%) patients while along with metformin and glimepiride in 10 (3.45%) patients. Patients who had diabetes for five years or less could be managed with single oral agent while two or three agents were required in patients having
diabetes for more than this period.

Conclusion: Adequate management of diabetes mellitus is difficult to be achieved with a single oral agent. Most of the patients require two or more drugs to achieve glycemic control. Newer antidiabetic agents have been prescribed in combination only. Pioglitazone has been the most frequently prescribed medication in combination with glipizide and metformin. Even with all these medications a tight glycemic control is achieved in very few patients which needs an attention.

Key words: Utilization; Antidiabetics; Pioglitazone; Sulfonylureas; Glycemic Control


 
ARTICLE TOOLS
Abstract
PDF Fulltext
Print this article Print this Article
How to cite this articleHow to cite this article
Citation Tools
Related Records
 Articles by Darshan J Dave
Articles by R K Dikshit
Articles by Anuradha M Gandhi
on Google
on Google Scholar
Article Statistics
 Viewed: 4726
Downloaded: 1046
Cited: 2

REFERENCES
1.Zimmet P. Supercourse. Epidemiology of Diabetes –Its history in the last 50 years. 2004 Jan 13. http//www.Pitt.edu/-super1-lecture-lec13271/-2k-.


2. Verma M, Paneri S, Badi P et al. Correlative study of duration of type 2 diabetes mellitus with glycosylated hemoglobin, insulin resistance and blood glucose. Asian Journal of Diabetology 2005;7:46-50.


3. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates and projections. Diabetes Care 1998;21:1414-31.
http://dx.doi.org/10.2337/diacare.21.9.1414
[
Pubmed]   

4. U.K. Prospective Diabetes Study Group: Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998;352:854-65.
http://dx.doi.org/10.1016/S0140-6736(98)07037-8


5. ADA: Standards of Medical Care in Diabetes-2006. Diabetes Care 2006;29:S4-42.
[
Pubmed]   

6. Shaya FT, Shin JY, Mullins D, Fatodu HO, Gu A, Saunders E. Medicaid Managed Care: Disparities in the Use of Thiazolidinediones Compared with Metformin. J Natl Med Assoc 2005; 97(4):493-7.
[
Pubmed]    [PMC Free Fulltext]   

7. Rajan SK, Sivakumar R, Arunaprakash J. The study of plasma glycosylated hemoglobin and fibrinogen levels in patients with type 2 diabetes mellitus and its complication. Asian Journal of Diabetology 2005;7:9-12.


8. Barnett AH. Redefining the role of thiazolidinediones in the management of type 2 diabetes. Vasc Health Risk Manag 2009;5(1):141-51.
http://dx.doi.org/10.2147/VHRM.S4664
[
Pubmed]    [PMC Free Fulltext]   

9. Lewis GL. Drug therapy in diabetes management. Nurse practitioner forum 1998; 2:58-65.


10. Scheen AJ, Lefebvre PJ. Oral antidiabetic agents- A guide to selection. Drugs 1998;55:225-36.
http://dx.doi.org/10.2165/00003495-199855020-00004
[
Pubmed]   

11. Miyazaki Y, Mahankali A, Matsuda M, Glass L, Mahankali S, Ferrannini E et al. Improved glycemic control and enhanced insulin sensitivity in type 2 diabetic subjects treated with pioglitazone. Diabetes Care 2001; 24:710-9.
http://dx.doi.org/10.2337/diacare.24.4.710
[
Pubmed]   

12. Langtry HD, Balfour JA. Glimepiride – A review of it use in the management of type 2 diabetes mellitus. Drugs 1998;55:563-84.
http://dx.doi.org/10.2165/00003495-199855040-00007
[
Pubmed]   

13. Hermann LS. Biguanides and sulfonylurea as combination therapy in NIDDM. Diabetes Care 1990;13:37-41.
[
Pubmed]   

14. Hermann LS, Schersten B, Bitzen PO, Kjellstrom T, Lindgarde F, Melander A. Therapeutic comparison of metformin and sulfonylurea, alone and in various combinations: a double-blind controlled study. Diabetes Care 1994; 17:1100-9.
http://dx.doi.org/10.2337/diacare.17.10.1100
[
Pubmed]   

15. Alberti KGMM, Gries FA. Management of non-insulindependant diabetes mellitus in Europe: a consensus view. Diabetic Med 1988;5:275-81.
http://dx.doi.org/10.1111/j.1464-5491.1988.tb00984.x
[
Pubmed]   

16. Lefebvre PJ, Scheen AJ. Management of non-insulindependant diabetes mellitus. Drugs 1992;44:29-38.
http://dx.doi.org/10.2165/00003495-199200443-00005


17. Alberti KGMM, Gries FA, Jervell J et al. A desktop guide for the management of non-insulin-dependant diabetes mellitus (NIDDM): an update. Diabetic Med 1994;11:899-909.
http://dx.doi.org/10.1111/j.1464-5491.1994.tb00376.x
[
Pubmed]   

18. Williams G. Management of non-insulin-dependant diabetes mellitus. Lancet 1995;343:95-100.
http://dx.doi.org/10.1016/S0140-6736(94)90822-2


19. American Diabetes Association. Consensus statement: the pharmacological treatment of hypoglycemia in NIDDM. Diabetes Care 1995;310:83-8.


20. Kimmel B, Inzucchi SE. Oral agents for type 2 diabetes: An update. Clinical Diabetes 2005;23:64-76.
http://dx.doi.org/10.2337/diaclin.23.2.64


21. Chan JL, Abrahamson MJ. Pharmacological management of type 2 diabetes mellitus: rational for rational use of insulin. Mayo clinic proceedings 2003; 78(4):459-67.
http://dx.doi.org/10.4065/78.4.459
[
Pubmed]   

22. Nolan JJ, Ludvik B, Beerdseen P, Joyce M, Olefsky J. Improvement in glucose tolerance and insulin resistance in obese subjects treated with troglitazone. N Eng J Med 1994;331:1188-93.
http://dx.doi.org/10.1056/NEJM199411033311803
[
Pubmed]   

23. Maggs DG, Buchanan TA, Burant CF, Cline G, Gumbiner B, Hsueh WA et al. Metabolic effects of troglitazone monotherapy in type 2 diabetes mellitus. A randomized, double-blind, placebocontrolled trial. Ann Intern Med. 1998; 128:176-85.
[
Pubmed]   

24. Frias JP, Yu JG, Kruszynska YT, Olefsky JM. Metabolic effects of troglitazone therapy in type 2 diabetic, obese, and lean normal subjects. Diabetes Care 2000;23:64-9.
http://dx.doi.org/10.2337/diacare.23.1.64
[
Pubmed]   

25. Petersen KF, Krssak M, Inzucchi S, Cline GW, Dufour S, Shulman GI. Mechanism of troglitazone action in type 2 diabetes. Diabetes 2000;49:827-31.
http://dx.doi.org/10.2337/diabetes.49.5.827
[
Pubmed]   

26. Gillies PS, Dunn CJ. Pioglitazone. Drugs 2000;60:333-43.
http://dx.doi.org/10.2165/00003495-200060020-00009
[
Pubmed]   

27. Paknikar S, Sarala N. Pharmacoeconomics of oral antidiabetic drugs. Asian Journal of Diabetology 2004;6:14-7.


28. Yki-Jarvinen H. Combination therapy with insulin and oral agents: optimizing glycemic control in patients with type 2 diabetes mellitus. Diabetes Metab Res Rev 2002;18:S77-81.
http://dx.doi.org/10.1002/dmrr.304
[
Pubmed]   

This Article Cited By the following articles

Prescription of Generic Drugs
National Journal of Physiology, Pharmacy and Pharmacology 2013; 3(1): 1.

1
 
Trends of articles published in National Journal of Physiology, Pharmacy and Pharmacology NJPPP
National Journal of Physiology, Pharmacy and Pharmacology 2013; 3(2): 102.

2
 
How to Cite this Article
Pubmed Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi. Utilization of some newer oral antidiabetic agents in a tertiary care hospital. Natl J Physiol Pharm Pharmacol. 2012; 2(2): 146-151. doi:10.5455/njppp.2012.2.146-151


Web Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi. Utilization of some newer oral antidiabetic agents in a tertiary care hospital. http://www.njppp.com/?mno=22224 [Access: December 11, 2018]. doi:10.5455/njppp.2012.2.146-151


AMA (American Medical Association) Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi. Utilization of some newer oral antidiabetic agents in a tertiary care hospital. Natl J Physiol Pharm Pharmacol. 2012; 2(2): 146-151. doi:10.5455/njppp.2012.2.146-151



Vancouver/ICMJE Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi. Utilization of some newer oral antidiabetic agents in a tertiary care hospital. Natl J Physiol Pharm Pharmacol. (2012), [cited December 11, 2018]; 2(2): 146-151. doi:10.5455/njppp.2012.2.146-151



Harvard Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi (2012) Utilization of some newer oral antidiabetic agents in a tertiary care hospital. Natl J Physiol Pharm Pharmacol, 2 (2), 146-151. doi:10.5455/njppp.2012.2.146-151



Turabian Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi. 2012. Utilization of some newer oral antidiabetic agents in a tertiary care hospital. National Journal of Physiology, Pharmacy and Pharmacology, 2 (2), 146-151. doi:10.5455/njppp.2012.2.146-151



Chicago Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi. "Utilization of some newer oral antidiabetic agents in a tertiary care hospital." National Journal of Physiology, Pharmacy and Pharmacology 2 (2012), 146-151. doi:10.5455/njppp.2012.2.146-151



MLA (The Modern Language Association) Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi. "Utilization of some newer oral antidiabetic agents in a tertiary care hospital." National Journal of Physiology, Pharmacy and Pharmacology 2.2 (2012), 146-151. Print. doi:10.5455/njppp.2012.2.146-151



APA (American Psychological Association) Style

Darshan J Dave, R K Dikshit, Anuradha M Gandhi (2012) Utilization of some newer oral antidiabetic agents in a tertiary care hospital. National Journal of Physiology, Pharmacy and Pharmacology, 2 (2), 146-151. doi:10.5455/njppp.2012.2.146-151





Most Viewed Articles
  • Applications of computer science in Pharmacy: An overview
    Shivraj Popat Jadhav, Komal Nikam, Anand Gandhi, Kishor Salunkhe, Narendra Shinde.
    Natl J Physiol Pharm Pharmacol. 2012; 2(1): 1-9
    » Abstract

  • How to calculate sample size in animal studies?
    Hitesh Shah
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 35-39
    » Abstract

  • Chlorhexidine:The gold standard in chemical plaque control [English]
    Setu mathur, Tanu mathur,Rahul shrivastava, Rohit khatri
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 45-50
    » Abstract

  • Assessment of Nutritional Status of Pregnant Women Attending the City Tebessa PMI (Algeria) [English]
    Taleb Salima, Kaibi Mounira, Deghboudj Nadjia
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 97-105
    » Abstract

  • Difference in pulmonary function test among the athletic and sedentary population
    ShobhaRani Vedala, Niranjan Paul, Abhay B Mane
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 118-123
    » Abstract & References » doi: 10.5455/njppp.2013.3.109-114

  • Analyzing Pharmaceutical Industry [English]
    Veselin Tima Dickov, Dragan Mitrovic, Boris Milan Kuzman
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 1-8
    » Abstract & References » doi: 10.5455/njppp.2011.1.1-8

  • Antidiabetic activity of alcoholic extract of Neem (Azadirachta Indica) root bark
    Prabhakar Patil, Sudha Patil, Abhay Mane, Sushilkumar Verma
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 142-146
    » Abstract & References » doi: 10.5455/njppp.2013.3.134-138

  • Second MBBS medical student’s feedback on teaching methodology and evaluation methods in Pharmacology
    Nilesh Chavda, Preeti Yadav, Jay Karan, N. D. Kantharia
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 23-31
    » Abstract & References » doi: 10.5455/njppp.2011.1.23-31

  • Prophylaxis and Treatment for Leptospirosis: Where are the Evidences?
    Jaykaran Charan, Deepak Saxena, Summaiya Mulla
    Natl J Physiol Pharm Pharmacol. 2012; 2(2): 78-83
    » Abstract & References » doi: 10.5455/njppp.2012.2.78-83

  • How to write a thesis? [English]
    Swapnil s Agarwal, Preeti Yadav, Krishnadutt Chavali, Lavlesh Kumar
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 86-90
    » Abstract

  • Most Downloaded
  • How to calculate sample size in animal studies?
    Hitesh Shah
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 35-39
    » Abstract

  • Applications of computer science in Pharmacy: An overview
    Shivraj Popat Jadhav, Komal Nikam, Anand Gandhi, Kishor Salunkhe, Narendra Shinde.
    Natl J Physiol Pharm Pharmacol. 2012; 2(1): 1-9
    » Abstract

  • Chlorhexidine:The gold standard in chemical plaque control [English]
    Setu mathur, Tanu mathur,Rahul shrivastava, Rohit khatri
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 45-50
    » Abstract

  • Difference in pulmonary function test among the athletic and sedentary population
    ShobhaRani Vedala, Niranjan Paul, Abhay B Mane
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 118-123
    » Abstract & References » doi: 10.5455/njppp.2013.3.109-114

  • Prophylaxis and Treatment for Leptospirosis: Where are the Evidences?
    Jaykaran Charan, Deepak Saxena, Summaiya Mulla
    Natl J Physiol Pharm Pharmacol. 2012; 2(2): 78-83
    » Abstract & References » doi: 10.5455/njppp.2012.2.78-83

  • Analyzing Pharmaceutical Industry [English]
    Veselin Tima Dickov, Dragan Mitrovic, Boris Milan Kuzman
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 1-8
    » Abstract & References » doi: 10.5455/njppp.2011.1.1-8

  • A study of oxidative stress in gentamicin induced nephrotoxicity and effect of antioxidant vitamin C in Wistar rats.
    Chetankumar R. Acharya, Hetal N. Thakar, S. K. Vajpeyee
    Natl J Physiol Pharm Pharmacol. 2013; 3(1): 14-20
    » Abstract & References » doi: 10.5455/njppp.2013.3.14-20

  • Second MBBS medical student’s feedback on teaching methodology and evaluation methods in Pharmacology
    Nilesh Chavda, Preeti Yadav, Jay Karan, N. D. Kantharia
    Natl J Physiol Pharm Pharmacol. 2011; 1(1): 23-31
    » Abstract & References » doi: 10.5455/njppp.2011.1.23-31

  • Antidiabetic activity of alcoholic extract of Neem (Azadirachta Indica) root bark
    Prabhakar Patil, Sudha Patil, Abhay Mane, Sushilkumar Verma
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 142-146
    » Abstract & References » doi: 10.5455/njppp.2013.3.134-138

  • Assessment of Nutritional Status of Pregnant Women Attending the City Tebessa PMI (Algeria) [English]
    Taleb Salima, Kaibi Mounira, Deghboudj Nadjia
    Natl J Physiol Pharm Pharmacol. 2011; 1(2): 97-105
    » Abstract

  • Most Cited Articles
  • A study of oxidative stress in gentamicin induced nephrotoxicity and effect of antioxidant vitamin C in Wistar rats.
    Chetankumar R. Acharya, Hetal N. Thakar, S. K. Vajpeyee
    Natl J Physiol Pharm Pharmacol. 2013; 3(1): 14-20
    » Abstract & References » doi: 10.5455/njppp.2013.3.14-20
    Cited : 8 times [Click to see citing articles]

  • Quercetin improved spatial memory dysfunctions in rat model of intracerebroventricular streptozotocin-induced sporadic Alzheimer’s disease
    Manouchehr Ashrafpour, Sahar Parsaei, Hamid Sepehri
    Natl J Physiol Pharm Pharmacol. 2015; 5(5): 411-415
    » Abstract & References » doi: 10.5455/njppp.2015.5.2308201563
    Cited : 8 times [Click to see citing articles]

  • A pilot study to evaluate the effect of HAART on gonadal dysfunction in male HIV patients
    Abhishek Pathak, Lalit Prashant Meena, Jaya Chakravarty, Madhukar Rai, Shyam Sundar
    Natl J Physiol Pharm Pharmacol. 2015; 5(1): 33-35
    » Abstract & References » doi: 10.5455/njppp.2015.5.120720142
    Cited : 6 times [Click to see citing articles]

  • Prevalence and risk factors for eating disorders in Indian adolescent females
    Amit A Upadhyah, Rajesh Misra, Deepak N Parchwani, Pankaj B Maheria
    Natl J Physiol Pharm Pharmacol. 2014; 4(2): 153-157
    » Abstract & References » doi: 10.5455/njppp.2014.4.041220131
    Cited : 5 times [Click to see citing articles]

  • Newer anti-platelet and anti-thrombotic drugs on the horizon
    Ajai Garg, Anjana Pandey, Pranab Oza, Mridul Chaturvedi
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 105-110
    » Abstract & References » doi: 10.5455/njppp.2013.3.090420131
    Cited : 5 times [Click to see citing articles]

  • Rate pressure product predicts cardiovascular risk in type 2 diabetics with cardiac autonomic neuropathy
    Rishu Segan, Vidushi Gupta, Lily Walia, Naveen Mittal
    Natl J Physiol Pharm Pharmacol. 2013; 3(1): 43-47
    » Abstract & References » doi: 10.5455/njppp.2013.3.43-47
    Cited : 4 times [Click to see citing articles]

  • Effects of sixteen weeks exercise training on left ventricular dimensions and function in young athletes
    Sandip M Hulke, Yuganti P Vaidya, Amandeepkour R Ratta
    Natl J Physiol Pharm Pharmacol. 2012; 2(2): 152-158
    » Abstract & References » doi: 10.5455/njppp.2012.2.152-158
    Cited : 4 times [Click to see citing articles]

  • Antidiabetic activity of alcoholic extract of Neem (Azadirachta Indica) root bark
    Prabhakar Patil, Sudha Patil, Abhay Mane, Sushilkumar Verma
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 142-146
    » Abstract & References » doi: 10.5455/njppp.2013.3.134-138
    Cited : 4 times [Click to see citing articles]

  • Difference in pulmonary function test among the athletic and sedentary population
    ShobhaRani Vedala, Niranjan Paul, Abhay B Mane
    Natl J Physiol Pharm Pharmacol. 2013; 3(2): 118-123
    » Abstract & References » doi: 10.5455/njppp.2013.3.109-114
    Cited : 4 times [Click to see citing articles]

  • Time domain measures of heart rate variability during acute mental stress in Type 2 diabetics- A case control study
    Anupama Deepak, Deepak A N, Shobha Nallulwar, Vitthal Khode
    Natl J Physiol Pharm Pharmacol. 2014; 4(1): 34-38
    » Abstract & References » doi: 10.5455/njppp.2014.4.080720131
    Cited : 4 times [Click to see citing articles]