Endocrine Abstracts

Objective: To study the usage of oral antidiabetic drug (OAD)s prescribed to T2DM patients by General Practitioners and to compare overall glycaemic status of different OAD users at the time of referral to a tertiary care clinic.

Methodology: T2DM patients attending a referral clinic underwent a proforma-based interview on their first visit. Data regarding subjects’ ongoing prescription (at least for preceding 3 months with a compliance rate ≥80%) of OADs such as sulfonylurea, metformin, thiazolidinediones, α-glucosidase inhibitors, incretin, glinides as prescribed by General Practitioners were collected. HBA1c levels were estimated by HPLC (BIORAD). Results were expressed as mean±s.d\. HbA1c in two comparative groups were compared using two-tailed Student’s t-test.

Results: Total 500 T2DM patients (male 61%, age 52.49±10.94 years, duration 7.31±6.16 years) were included in the study (attending clinic between November 2009 and February 2013). Only 24% of subjects were on monotherapy (using any one of the six OAD groups) at the time of referral. Average duration of diabetes in patients who were on monotherapy was 6.7±6.8 years whereas that of polytherapy was 7.5±5.9 years. The glycemic status as indicated by HbA1c level between these two groups has a highly significant difference (7.92±2.14 vs 8.79±2.16; P=0.000142). The most commonly used single OAD was sulfonylurea (52%) followed by metformin (34%). However, HbA1c level between these two groups did not differ much (7.85±1.84 vs 7.92±2.07; P=0.80). Sulfonylurea plus metformin (52%) was the most preferred combination of antidiabetic therapy. About 30% of patients were on triple drug therapy, the most commonly used combination being that of sulfonylurea plus metformin plus thiazolidinediones.

Conclusion: Sulfonyurea is the mostly preferred oral antidiabetic drug as monotherapy by the general practitioners of North-East India. Patients on polytherapy have a longer duration of diabetes and poorer control. This study indicates the current trend of diabetes practice prevailing in North Eastern part of India.