Appropriateness of Type 2 diabetes mellitus drug therapy: A case of Tikur Anbessa Specialized Hospital Diabetes Clinic
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Date
2014-03
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Addis Ababa University
Abstract
Background: Diabetes mellitus (DM) is a metabolic problem involving chronically high blood
glucose levels or hyperglycemia, which is thought to arise from insulin deficiency. This insulin
deficiency can be decrease in amount or a complete absence in body. In the long run high blood
glucose level could lead to various complications. Beside altered glucose metabolism carbohydrate,
protein, and lipids metabolisms are also affected in diabetes mellitus.
Objective: To assess appropriateness of Type 2 diabetes mellitus drug therapy (T2DM) and
investigate association between fasting blood glucose (FBG) and the patients’ clinical and
demographic characteristics at the diabetes clinic of Tikur Anbessa specialized hospital (TASH).
Methods: The study was a cross sectional hospital based survey and used both quantitative and
qualitative methods. T2DM patients who came for their follow up treatment at the diabetes clinic of
TASH over a one month period (April 2013) were used as research participants. Plus key informant
interview with the help of semi-structured open ended questioner was used focusing on the
experience and practice physicians within the diabetes clinic regarding medication choice and
guidelines they use.
Results: A total of 103 patients enrolled in the survey and the proportion of females (59.2%) was
higher than males (40.8%). The mean age was 52.2 years and most of them live in Addis Ababa.
When it comes to clinical characteristics mean FBG was 155.99 ± 44.32 mg/dl, the difference in
FBG between male and female was insignificant (P=0.325). Body mass index (BMI) had a mean
value of 26.4± 3.05 kg/m2 and 51.45% of the patients were overweight. Medication wise NPH
(56.3%), metformin plus glibenclamide (19.4%) and metformin (10.7%) were the most prescribed
drug therapies. And 3.88% of patients were only on glibenclamide. The association of gender, age,
BMI and medication used with the FBG levels of patients was not significant with a p value of 0.6,
0.803, 0.97 and 0.081 respectively. The key informants point out that patient load, physician
rotation, lack of guide-line and devices as a reason for inadequacy of treatment.
Conclusions: The treatment of T2DM is appropriate with existing problems. Metformin was the
first choice oral medication, while most patients were on NPH. And no single factor was associated
with influencing the FBG of patients.
Key Words: Type 2 diabetes mellitus, Drug therapy
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Keywords
Type 2 diabetes mellitus; Drug therapy Acknowledgments