Abstract

Diabetes mellitus is a pandemic disease that has struck each and every corner of the world. According to the Indian Council of Medical Research-Indian Diabetes study (ICMR), a national diabetes study, India currently has 62.4 million people with diabetes. This is set to increase to over 100 million by 2030. The prevalence of diabetes among adults has reached approximately 20% in urban and approximately 10% in rural populations in India. Materials and Methods: This prospective observational study was carried out for a period of 1 year from January 2023 to December 2023 at Department of General Medicine, Tagore Medical College Hospital, Rathinamangalam, Melakottaiyur, Chennai. A total of 1113 patients were screened, from which 138 cases of DM aged between 20 to 80 yrs. Who were under treatment and following life style modification and diet advice were included in the study. Majority of the patients belonged to low and middle socioeconomic groups. Patients not willing for informed consent, those with diabetic complications and serious medical conditions requiring subsequent hospital admissions, prediabetic status, Gestational Diabetes were excluded from the study. Results: The prevalence was about 6.19% and 68.11% of them were 40-60 years of age. Metformin was the most commonly prescribed drug and 21.74% of patients were on monotherapy. Glimepiride and Metformin (33.33%) was the mostly used oral combination followed by Glibenclamide and Metformin (8.69%). Inj. Human Mix insulin with Metformin was used in 27.53%. 15.94% of patients were on statins. The most common comorbid condition was hypertension (21.73%) followed by dyslipidaemia (8.6%). Conclusion: With increasing prevalence of the disease, this study provides an insight to create awareness about the drug usage among rural population. OADs are still the predominantly prescribed drugs, but there was a shift towards the use of insulin in the management of Type 2 diabetes mellitus. Intensification of current drug treatment as well as planning multiple drug interventions with lifestyle modification is necessary. Metformin is the most commonly used drug and among the sulfonylureas Glimepiride is the most commonly used.

Description

Diabetes mellitus is a pandemic disease that has struck each and every corner of the world. According to the Indian Council of Medical Research-Indian Diabetes study (ICMR), a national diabetes study, India currently has 62.4 million people with diabetes. This is set to increase to over 100 million by 2030. The prevalence of diabetes among adults has reached approximately 20% in urban and approximately 10% in rural populations in India.1 Various classes of anti-diabetic drugs including insulin and oral hypoglycemic agents (OHA) are currently used in the treatment of diabetes, which acts by different mechanisms to reduce the blood-glucose levels to maintain optimal glycemic control.2 Intense blood glucose control helps to significantly reduce microvascular complications and many different classes of ant diabetic drugs are used to attain a good glycemic control.3 Though we have a better understanding of the pathophysiology of diabetes and have developed many new drugs, still the overall diabetic control seems inadequate; probably due to clinical inertia of the treating physician, lack of patient compliance, or improper life style modification. In majority of patients the control of diabetes and associated factors like hypertension and lipids seems inadequate resulting in more number of complications.4 Urbanization, western diet and sedentary life style has led to an increased incidence of diabetes in rural areas of India. Not many studies have focused on drug usage pattern in rural parts of South India.5 Hence, we planned this study to evaluate the drug usage pattern among diabetic patients in a rural population in South India.