Endocrine Abstracts

Introduction: The frequent polypharmacy in diabetic patients, because of the complications of the disease, drug interactions can occur when two or more drugs are taken in combination. The objective of our work was to determine the relative frequency of these drug interactions, to identify the types and to evaluate the impact or the repercussion of these in the diabetic, in order to deduce the practical behaviors.

Patients and methods: Prospective study, conducted over 3 months from December 2017 to February 2018 in the endocrinology department of Ibn Rochd University Hospital, in 50 diabetic patients. The prescriptions were analyzed using the Vidal database.

Results: The mean age of the patients was 53 years (22–84). The sex ratio of 0.23 H/F, an average BMI of 29.58 kg/m². Predominant type 2 diabetes (84%), mean age of 11.48 years, mean HbA1c of 10.81 (6.2%–14.3%). Degenerative complications: Retinopathies (18%), nephropathies (4%), neuropathies (56%) and comorbidities: hypertension and dyslipidemia (58%), IDM and AOMI (4%). The number of prescriptions per prescription was 7.18, self-medication (12%) and drug interactions (52%), 2 per prescription. We noted precautions for use (71%), associations to take into account (26%) and disadvised (3%). No contraindications were noted. The main categories of drugs at the origin of interactions: antihypertensives (98%) (calcium blockers (ICA), beta-blockers, converting enzyme inhibitors (IEC), diuretics…), insulins (96%), Oral antidiabetic agents (74%) (Biguanide, hypoglycemic sulfonamides, GLP-1 analogue), antibiotics (72%) (fluoroquinolones, cephalosporins 3G), and statins (52%). The most common adverse events observed were hydroelectric disorders with hyperkalemia (17%), hypokalemia (1%), hyponatremia (9%). The most common potential risks were hypoglycemia (19%) and low blood pressure (14%). The majority of the patients affirmed the respect of the medical prescription.

Conclusion: Particular vigilance should be given to this population in order to minimize the clinical occurrence of major drug interactions in diabetic patients.