Navas Nadukkandiyil, Hanadi Khamis Al Hamad, Noorudeen Kaladi Kunnummal, Marwan Badri Ramadan, Maryam Al Obaidely, Haroon Saleh, Mansoor Ali, Shirmila Syamala, Faizal Umminiyattle, Amin Abdelghany, Sameer Acharath Valappil, Shafi Hashmath Khan and Essa Al Sulaiti
Background: Type 2 Diabetes Mellitus (T2DM) is generally a costly illness and related to significant mortality and morbidity. In spite of this, there is only little information available on clinical outcome and ‘real-world’ medication utilization patterns for middle age and older patients with T2DM. Therefore, the main aim of the study is to evaluate the Medication Utilization Pattern and Clinical outcomes of T2DM for middle age and older patients.
Methods: A retrospective longitudinal study was conducted for a period of six months after getting approval from a medical research center (IRB No #15175) in an out-patient department of a tertiary hospital in Doha, Qatar. The outpatients with T2DM, around 60 years of age were included in the study. The sample size for the study was 150 middle-aged and older patients from a total of 800 patients who attended Rumailah hospital Geriatric outpatient clinic during the study period. The gathered data was stored with identifier code in the shared drive for 2 years after the completion of study for verification purpose and future studies if any; it was shared with all internal collaborators. The gathered data was analyzed using SPSS v2.0 (Statistical Package for Social Sciences version 20 Inc. USA). The method for the analysis was continuous variable analysis using student t-test or one-way ANOVA, for skewed continuous data, a non-parametric Mann-Whitney test, and categorical variables were compared using chi-square test and the associations between DM, socio-demographic and clinical indicators were evaluated.
Results: The results show that the combination of anti-diabetic therapy was more used than monotherapy. The study found a slight but significant positive correlation between age and HbA1C in addition to Fasting Blood Sugar (FBS) and Glycated hemoglobin (HbA1c) levels. Under different treatment regimens, a majority of 118 older patients were using Metformin; for insulin, the most commonly used treatment regimen is Glargine Insulin; with regards to anti-hypertensive, Amlodipine is the most prescribed medication for patients followed by Beta Blocker, as Metoprolol. The use of a combination of Metformin/Sitagliptin or Vildagliptin showed higher Non-Insulin Anti-Diabetic (NIAD) drug prescriptions as per the target attained between HbA1c which was 7.0 to 8.0% in healthy older patients.
Conclusion: In a large cohort of patients with DM, an overall satisfactory quotient was achieved in treatment quality; however, applicable proportions of patients had below or above the target range of recommended HbA1C values. The fundamental treatment patterns varied from general diabetes with an extraordinarily higher percentage and more than 50 percentage getting insulin-based therapies which were related to high probability of HbA1C levels >7%.