ABSTRACT
Background: Polytherapy and comorbidities are a significant component of drug prescriptions in type 2 Diabetes mellitus (T2DM) patients. Irrational prescriptions and increased cost and number of drug therapies in T2DM put a considerable burden on patients as well as health authorities. Drug utilization studies are a very important tool in the evaluation of such prescriptions for logistical planning and medical audit of a health care setup. Aims and Objectives: To determine the drug utilization patterns of Antihyperglycaemic agents in diabetic patients attending medicine outpatient department and to assess average cost per prescription and to assess the economic implication. Materials and Methods: A prospective observational drug audit was carried out between January 2017 to June 2018 to determine drug utilization patterns of antihyperglycemic and other agents in T2DM patients attending medicine outpatient department of Konaseema Institute of Medical Science General Hospital, Amalapuram. The data were assessed using the World Health Organization indicators for drug utilization and analyzed using mean percentage and Chi-square tests. Value of P < 0.05 was taken as significant. Results: Metformin had highest Defined Daily Dose of 0.77 and was the most common drug prescribed both as monotherapy (14%) and in combination therapy with glimepiride (42.5%). Amlodipine (15.5%) was the most common non-diabetic drug prescribed in our patients. Average number of drugs per prescription was 3.05, while average number of antihyperglycemic agents per prescription was 1.81. Average cost per prescription was under rupees 50 in 30% of patients and all drugs were prescribed by their brand names. Conclusion: Metformin should be available in sufficient quantities in health care system for T2DM patients and drugs should be prescribed by generic names to reduce cost of drug treatment.
ABSTRACT
Background: Diabetes mellitus is associated with cognitive, neurophysiological, and structural changes in the central nervous system. Aim and Objective: The aim of the study was to evaluate the effect of Ficus benghalensis on cognitive behavior and acetylcholinesterase levels in brain of diabetic rats, and to compare with Piracetam and Glimepiride. Material and Methods: Wistar rats of either sex weighing 150–200 g were randomized into ten groups of ten each (five groups of diabetic rats and five groups of non-diabetic rats) where one group of diabetic and one group of non-diabetic rats each received F. benghalensis dose I (50 mg/kg), F. benghalensis dose II (100 mg/kg), Piracetam (200 mg/kg) and Glimepiride (0.5 mg/kg), and one group of diabetic rats and one group of non-diabetic rats served as the control group. The blood glucose levels were assessed at 0 and 30th days. The assessment of acquisition phase of each cognitive behavior test was done on 0, 14th, and 29th days, whereas retention phase was assessed on 1st, 15th, and 30th days. Results: In comparison with diabetic control group, F. benghalensis at both doses showed significant decrease in blood glucose levels as well as acquisition and retention of Transfer Latency in elevated plus maze on 29th and 30th days, respectively. Further, both doses exhibited significant increase in retention of step-down latency (SDL) on 30th in continuous avoidance apparatus, but only dose II showed significant increase in acquisition of SDL on 29th day. Similarly, significant increase in retention of Quadrant-time in Morris Water Maze was also observed with both doses of F. benghalensis and other groups compared to controls on 30th day. However, significant decrease in brain AChE level, was observed with only F. benghalensis dose II. Conclusion: Overall, the positive effects of F. benghalensis on cognition were comparable to other two groups, namely, Piracetam and Glimepiride. Hence, it can be concluded that F. benghalensis might be effective in alleviating the behavioral and biochemical changes in diabetes mellitus.