A global analytical molecular pharmacological study of the endocrinological pharmacotherapeutic rationale of anti-diabetic prescriptions appraisal attributes for metformin and sitagliptin, with evaluation of anti-diabetic tertiary medical healthcare patient satisfaction
Keywords:Biguanides, Dipeptidyl peptidase-4 inhibitors, Prescription’s appraisal, Patient compliance, Molecular Pharmacology, Anti-diabetic medical healthcare patient satisfaction
Background: The inhibition of dipeptidyl peptidase-4 by anti-diabetic drugs dipeptidyl peptidase-4 inhibitors enhances hormonal activity of incretins (GLP-1, GIP, GRP), stimulates insulin release and reduces glucagon secretion, producing anti-hyperglycaemic activity among type II diabetics. The objective of this study was a global analytical molecular pharmacological study of the endocrinological rationale of anti-diabetic prescriptions appraisal attributes for metformin and sitagliptin, along with anti-diabetic tertiary medical healthcare patient satisfaction evaluation.
Methods: 100 new early moderate grade type II diabetics were prescribed oral metformin 500 mg or sitagliptin 25 mg once daily for 3 months, in monotherapy, or in combination therapy, or in a mixed regimen of monotherapy and combination therapy. The patients’ endocrinological pharmacotherapeutic compliance was analysed. The number of prescriptions for metformin and sitagliptin was recorded; and prescription percentages were calculated. The completeness and molecular basis of prescription content attributes were analysed. The molecular basis of anti-diabetic pharmacotherapeutics, was analysed. The anti-diabetic tertiary medical healthcare patient satisfaction was evaluated by patient response to different attributes of anti-diabetic treatment.
Results: All the patients had completed the study, with no adverse effects related drop-out, lost to follow-up or voluntarily withdrawn patients. The prescription rates of metformin was 75% (75 prescriptions), followed by sitagliptin: 25% (25 prescriptions).100% prescriptions were complete for each prescription content attribute. The molecular pharmacotherapeutic response mechanisms were significantly efficacious. All the patients were satisfied with each anti-diabetic medical healthcare attribute.
Conclusions: The patient endocrinological pharmacotherapeutic compliance was significantly high. Metformin was most commonly prescribed, followed by sitagliptin. The prescription content analyses showed 100% completeness, with significant pharmacotherapeutic molecular efficacy. There was ample anti-diabetic medical healthcare satisfaction.
Hazra M. An endocrinological pharmacovigilance study on the safety assessment of metformin monotherapy and the combination therapy of remogliflozin with metformin, in the new type II diabetes mellitus patients, in tertiary care medical college hospitals. World J Pharm Res 2021;10(11): 1443-53.
Hazra M. A study of the usual clinical pharmacological prescription patterns of metformin, Sitagliptin, and Remogliflozin among the early moderate grade new type ii diabetes mellitus patients in tertiary care hospitals. Int J Sci Stud 2021;9(5):1-4.
Hazra M. A clinical pharmacological study of the prevalent prescription patterns of metformin, sitagliptin and gemigliptin among the early moderate grade new type II diabetes mellitus patients in global tertiary care hospitals. Int J Pharm Sci Rev Res 2021; 70(1):180-4.
Dharmalingam M, Aravind SR, Thacker H, Paramesh S, Mohan B, Chawla M, et al. efficacy and safety of remogliflozin etabonate, a new sodium glucose co-transporter-2 inhibitor, in patients with type 2 diabetes mellitus: A 24 week, randomized, double-blind, active controlled trial. Drugs. 2020;80:587-600.
American diabetes association. Pharmacologic approaches to glycaemic treatment: standards of medical care in diabetes-2021. Diabetes Care. 2021; 44 (Suppl. 1):S111-24.
Le TD, Nguyen NTP, Nguyen ST, Tran HTT, Nguyen LTH, Duong HH, et al. Sitagliptin increases beta-cell function and decreases insulin resistance in newly diagnosed vietnamese patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2020;13:2119-27.
Solerte SB, D’Addio F, Trevisan R, Lovati E, Rossi A, Pastore I, et al. Sitagliptin treatment at the time of hospitalization was associated with reduced mortality in patients with type 2 diabetes and COVID-19: a multicenter, case-control, retrospective, observational study. Diabetes care. 2020;43:2999-3006.
LaMoia TE, Shulman GI. Cellular and molecular mechanisms of metformin action. Endocr Rev. 2021; 42:77-96.
Hussey EK, Kapur A, O’Connor-Semmes R, Tao W, Rafferty B, Polli JW, et al. Safety, pharmacokinetics and pharmacodynamicsof remogliflozin etabonate, a novel SGLT2 inhibitor, and metformin when co-administeredin subjects with type 2 diabetes mellitus. BMC Pharmacol Toxicol. 2013;14:25.
Zaccardi F, Jacquot E, Cortese V, Tyrer F, Seidu S, Davies MJ, et al. Comparative effectiveness of gliclazide modified release versussitagliptin as second-line treatment after metformin monotherapy in patients with uncontrolled type 2 diabetes. Diabetes Obes Metab. 2020;22:2417-26.
Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. Consensus statement by the American association of clinical endocrinologists and american college of endocrinology on the comprehensive type 2 diabetes management algorithm 2016 executive summary. Endocr Pract. 2016;22:84-113.
Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American diabetes association and the European Association for the study of diabetes. Diabetologia. 2015;58:429-42.
Tewarya S, Lucasa ES, Fujiharaa R, Kimanid PK, Polanco A, Brightona PJ. Impact of sitagliptin on endometrial mesenchymal stem-like progenitor cells: a randomised, double-blind placebo-controlled feasibility trial. EBio Medicine. 2020;51:1-10.
Raji A, Xu ZJ, Lam RLH, O’Neill EA, Kaufman KD, Engel SS. Efficacy and safety of sitagliptin compared with dapagliflozin in people 65 years oldwith type 2 diabetes and mild renal insufficiency. Diabetes Ther. 2020;11:2419-28.
Wang YW, He SJ, Feng X, Cheng J, Luo YT, Tian L, et al. Metformin: a review of its potential indications. Drug Des Devel Ther. 2017;11:2421-9.