RESUMO
Background: This study aimed to gather the clinicians� perspective regarding the use and prescription practice of dual combination oral anti-diabetic drugs (OADs) in type 2 diabetes mellitus (T2DM) management in Indian settings. Methods: A cross-sectional study was conducted by using a 29-item structured questionnaire covering factors considered, challenges, preferred indicators of glycemic control, continuous glucose monitoring (CGM) use, and strategies. Additionally, it explored clinicians' feedback and experiences with dual combination oral anti-diabetic drugs in T2DM management. Results: Seventy percent of clinicians observed improved adherence to dual combination therapy of OAD. The combination of dipeptidyl-peptidase 4 (DPP4) inhibitors and metformin was favored for early initiation and showed better tolerability within the first year according to 42% of clinicians. Approximately 63% of clinicians prefer vildagliptin + metformin for 40� year-old diabetics. The combination yields favorable outcomes: 21% in young, 14% in elderly, and 7% in long-standing diabetes cases. After 5 years, 37% of clinicians observed 40-50% of diabetics reaching an HbA1c goal of <7.0% with this combination. Clinicians choose glimepiride + metformin for treatment intensification based on its efficacy, cardiovascular (CV) safety, and fewer adverse events. These factors were collectively recognized by 66.54% of respondents. Conclusions: This study provided valuable insights into real-world clinical practices and preferences regarding dual combination therapy for diabetes management. Clinicians identified the fixed-dose combination of DPP4 inhibitors and metformin as the preferred choice and highlighted the effectiveness of glimepiride + metformin in overcoming treatment intensification challenges.
RESUMO
Background: Diabetes mellitus (DM) is a chronic progressive metabolic disorder associated with microvascular and macrovascular complications in type 2 DM. Oral anti-diabetic drugs (OADs) play an important role in regulating raised blood glucose levels and compliance to treatment. Aims and Objectives: The aims of this study were to evaluate cost variations of different brands of drug formulations in the management of DM. Materials and Methods: This study was an analytical study. Costs of various OADs were obtained from January to March 2022 edition of current index of medical specialties India. The cost ratio and percentage of variation among different drugs in the treatment of DM available in Indian Market and Manufactured by different pharmaceutical companies were analyzed. Results: The percentage variation in cost among commonly prescribed single OADs was found to be highest for sulfonylurea group of dugs Glimepiride 1 mg tablet (1.366%), followed by Biguanides, Metformin 500 mg tablet (809%), ?-Glucosidase inhibitors, and Voglibose 0.3 mg tablet (571%), while it was lowest for Glibenclamide 5 mg tablet (36%) and Acarbose 25 mg tablet (36%) of sulfonylurea drugs and ?-Glucosidase inhibitors group of drugs, respectively. In combination drug therapy, Glibenclamide and Metformin combination (1.25 + 250 mg tablet) shows maximum variation (132%). Conclusion: There is a wide difference existing in the cost of various oral anti-diabetics available in Indian Market by different brands. The physicians must be aware of these variations and prescribe medicines accordingly, while considering the financial status of patient and also to promote adherence to treatment.
RESUMO
Background: Diabetes mellitus is a chronic disease with a high mortality and morbidity. Knowledge regarding the disease is required for the management of drug adherence in diabetes, hence the present study was taken to assess the effectiveness of health education on knowledge regarding oral anti-diabetic drug adherence.Methods: The study was conducted at urban health training centre of a medical college, Bengaluru from October 2015 to July 2016. A total of 70 type 2 diabetes mellitus patients were involved in this descriptive and interventional study. The study subjects included only on oral anti-diabetic drugs and willing to give informed consent. A pre-tested semi-structured proforma was administered and information about socio-demographic profile, and impact of health education intervention on knowledge was obtained.Results: Most of the subjects were female (80%), in the age group of 35-45 years (34%), illiterate (40%), unemployed (67%) with class IV (78%) socio-economic status according to Modified Kuppuswamy classification 2014. The mean±SD age was 52.47±11.06 years. Significant improvement in knowledge regarding adherence to oral anti-diabetic medication was found in study subjects following health education intervention.Conclusions: The study revealed that health education regarding the importance of drug adherence is needed in study subjects and there was significant improvement in knowledge after health education.
RESUMO
Background: Diabetes Mellitus is a chronic metabolic disorder, one of the major causes of morbidity, mortality and needs lifelong treatment. There are large numbers of oral anti-diabetic drugs available for the treatment of type 2 diabetes mellitus. There are numerous brands available for each of the individual oral anti-diabetic drug. Thus, a study was planned to find out cost variation among different brands of same active oral anti-diabetic drug.Methods: Cost of a particular drug being manufactured by different companies, in the same strength and dosage forms was obtained from the price list provided by the pharmaceutical companies in Current Index of Medical Specialities (CIMS) (October 2017- January 2018). The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and percentage variation in price was analyzed.Results: Percentage cost variation of the commonly used drugs found was seen highest with Sulfonylureas (Glimepiride - 562%) followed by Metformin (492%) which was followed by Pioglitazone (488%), DPP-4 inhibitor Teneligliptin (231%), α- glucosidase inhibitors (Voglibose 284%), Meglitinides (Repaglinide 0.5mg 154%) and lowest was seen with Repaglinide 2mg (15%).Conclusions: There is very wide cost variation among different brands of the same oral anti-diabetic drugs manufactured in India. The average percentage cost variation of different brands of the same oral anti diabetic drugs manufactured in India is very wide. The appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences.