Analysis of Therapeutic Outcome of Antidiabetic Medications in a Tertiary Care Hospital - An Observational Study

Abstract

Background: Diabetes at present appears as a common non communicable disease. It leads to high morbidity and mortality due to the disease itself and its diverse complications like coronary artery disease, hypertension, renal complication, retinal damage, neurological disorders, incidence of stroke at different sites, generalized infections etc. With such multifactorial background of high prevalence , progressive nature of the disease leading to various complications and increase health care cost, availability of multiple therapeutic regimens prescribed on trial and error basis, the treatment is individualized and neither complete nor satisfactory. This study was undertaken to analyze the effect of antidiabetic medications on prognosis of the disease i.e. on glycemic status, lipid profile and on existing co-morbid conditions like hypertension and complications. Methods: This is a prospective, parallel group, comparative observational study. The enrolled patients were then divided as -Pre obese- categorized into a)New diabetic b)Old diabetic (<3 years duration). Obese similarly divided to a)New diabetic b)Old diabetic (<3 years duration). Each category was further divided into four subgroups according to the treatment received a)Monotherapy-only Metformin b)Combination therapy- Metformin another antidiabetic groups, preferably sulfonylureas, alphaglucosidase inhibitors or DPP 4 inhibitors c)Triple therapy (Metformin+SU +Voglibose or Gliptins or Glitazones) d)Insulin with other oral hypoglycemic drugs. Results: In primary outcome, reduction in all glycemic parameters were significant and progressive in both old and new diabetic cases at all follow up visits, both in preobese and obese groups. Analysis of secondary outcome revealed significant reduction in SBP, DBP and ACR in all the four groups while only LDL and Cholesterol were significantly reduced in all preobese and obese groups. Conclusions: The antidiabetic medications prescribed in this hospital, were effective in improving the glycemic status, blood pressure, lipid profile and renal status of all patients under the study.