Antidiabetic Prescription and Glycemic Control in Patients With Type 2 Diabetes Mellitus
AbstractObjective: To detertmine the antidiabetic treatment among individuals with type 2 diabetic patients in Mosul city, the number of patients who attained the glycemic target (good glycemic control) and patients who failed to attained glycemic target (poor glycemic control) and to investigate factors that may be associated with poor glycemic control.
Patients and Methods: 299 patients with type 2 diabetes mellitus of both sexes were participated in this study. The patients were divided into 2 groups according to the values of HbA1C: Group 1 (good glycemic control) and group 2 (poor glycemic control). A questionnaire form was prepared to record detailed informations about each patient such as age, drugs used, education level, diabetic family history, adherence to treatment, exercise, and diet. HbA1c level was analyzed using high performance liquid chromatography. Other parameters including total cholesterol, high density lipoprotein-cholesterol (HDL), triglycerides, low density lipoprotein-cholesterol (LDL) and serum glucose concentration were measured using special kits.
Results: The antidiabetic drugs used including metformin, glibenclamide and glimepiride, used alone and in combinations including metformin plus glibenclamide and metformin plus insulin. Fifty patients (16.7%) have good glycemic control and 249 patients (83.3%) have poor glycemic control. Comparison between number of poor glycemic control of metformin and glibenclamide showed non significant difference. Comparison between poor glycemic control of metformin plus glibenclamide and metformin plus insulin showed highly significant difference. Comparison between mono-therapy and combination therapy showed highly significant difference. High proportions of poor glycemic control were obtained with ages >40 males, overweight and obese, low educational level, family history of diabetes, use of herbs, long duration of the disease, low HDL-cholesterol, high atherogenic index, non adherence to treatment, diet and exercise.
Conclusion: This study showed that high proportions of type 2 diabetic patients were on combination therapy and the high proportions of the patients were poor glycemic control. Many factors were found to be associated with poor glycemic control including age >40 males, overweight and obesity, low educational level, family history of diabetes, use of herbs, long duration of the disease, non adherence to treatment, diet, and exercise.
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