Utilization pattern of oral hypoglycemic agents for diabetes mellitus type 2 patients attending out-patient department at tertiary care centre in Bhopal, Madhya Pradesh, India

Jambu Jain, Parag Sharma, Jigisha Jain, Mustafa Raja


Background: Diabetes mellitus type 2 is a chronic disease that may be due to insulin deficiency and insulin resistance or both. The resultant hyperglycemia leading to micro and macro vascular complications.The objective was to evaluate drug utilization pattern of oral hypoglycemic agents in type-2 diabetic attending OPD.

Methods: A prospective study was carried out in 200 out patients for a period of 3 months in a tertiary care hospital. Patients treated with oral hypoglycemic agents were taken for the study.

Results: In the present study 102(51%) were male. Majority (40%) of patient were in the age group 50-60 years. Metformin was the most commonly prescribed drug (38.3%), followed by sulfonylurea class of drugs (35.6%). Majority of the patients n=143(71.5%) were on combination therapy in comparision to monotherapy (28.5%). Fixed dose combinations more preferred more. Brand name was prefered (98.1%) on generic drugs. Comorbid condition was found in 117 patients (58.5%).  And hypertension (34%) was the the most common comorbid condition. The average number of antidiabetic drugs per prescription was 2.2.

Conclusions: Metformin was the most commonly used drug .The prescribing trend also appears to be more towards combination therapy. It was seen that particularly two drug were used.


Drug utilization, Oral hypoglycaemic drugs, Sulfonylurea, Monotherapy, Metformin

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Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. British Med J. 2000;321:405-12.

Gerstein HC, Miller ME, Byington RP, Goff Jr DC, Bigger JT, Buse JB, et al. Effects of intensive glucose lowering in type 2 diabetes. New England J Med. 2008;358:2545-9.

Patel A, Macmahon S, Chalmers J, Neal B, Billot L, Woodward M, et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. New England J Med. 2008;358:2560-72.

Raz I, Wilson PW, Strojek K, Kowalska I, Bozikov V, Gitt AK, et al. Effects of prandial versus fasting glycaemia on cardiovascular outcomes in type 2 diabetes: the heart 2d trial. Diabetes Care. 2009;32:381-6.

Davis SN, Granner DK. Insulin, oral hypoglycemic agents and the pharmacology endocrine pancreas. In: Hardman, J.G. and Limbird, L.E., Eds., Goodman and Gilman’s Pharmacological Basis of Therapeutics. McGraw Hill, New York, 2001:1526-1531.

Campbell IW, Lebovitz H. Fast facts-diabetes mellitus; what is type 2 diabetes? 2nd Edition, Health Press Ltd., Oxford. 2000:18-25.

Ahmann AJ, Riddle MC. Current oral agent for type 2 diabetes. Postgraduate Medicine. 2002;111:32-46.

IDF Diabetes Atlas. 7th ed. International Diabetes Federation, 2015. Available at: Accessed on 14 March 2016.

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998;21(9):1414-31.

Unger J. Current strategies for evaluating, monitoring, and treating type 2 diabetes mellitus. Am J Med. 2008;121(6):3-8.

Krentz AJ, Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs. 2005;65(3):385-411.

El-Kaissi S, Sherbeeni S. Pharmacological management of type 2 diabetes mellitus: An update. Curr Diabetes Rev 2011;7(6):392-405.

Lee D, Bergman U. Studies of drug utilization. In: Strom BL, editor. Pharmacoepidemiology. 4th ed. New York: John Wiley and Sons;2005:401.

Boccuzzi SJ, Wogen J, Fox J, Sung JCY, Shah AB, Kim J. Utilization of oral hypoglycemic agents in a drug-insured U.S. population. Diabetes Care. 2001;24:1411-5.

Chan TYK, Lee KKC, Chan AWK, Critchley JAJH. Utilization of antidiabetic drugs in Hongkong: relation to the common occurrence of antidiabetic drug-induced hypoglycemia amongst acute medical admissions and the relative prevalence of NIDDM. Int J Clin Pharmacol Ther. 1996;34(1):43-6.

Niskanen L, Enlund H, Jormanainen V, Nissinen N, Uusitupa M. Therapeutic traditions in type 2 diabetes- are they changing? Eur J Clin Pharmacol. 1994;46(2):101-5.

Kannan, Arshad, Kumar S. A study on drug utilization of oral hypoglycemic agents in type-2 diabetic patients. Asian J Pharm Clin Res. 2011;4:60-4.

Dave DJ, Dikshit RK, Gandhi AM. Utilization of some newer oral antidiabetic agents in a tertiary care hospital. Natl J Physiol Pharm Pharmacol. 2012;2(2):146-51.

Upadhyay DK, Palaian S, Ravi Shankar P, Mishra P, Sah AK. Prescribing pattern in diabetic outpatients in a tertiary care teaching hospital in Nepal. J Clin Diagn Res. 2007;3:248-55.

Jimoh AO, Sabir AA, Chika A, Sani Z. Pattern of antidiabetic drugs use in a diabetic outpatient clinic of a tertiary health institution in Sokoto, North-western Nigeria. J Med Sci. 2011;11:241-5.

Vengurlekar S, Shukla P, Patidar P, Bafna R, Jain S. Prescribing pattern of antidiabetic drugs in Indore city hospital. Indian J Pharm Sci. 2008;70(5):637-40.

Patel B, Oza B, Patel KP, Malhotra SD, Patel VJ. Pattern of antidiabetic drugs use in type 2 diabetic patients in a medicine outpatient clinic of a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2013;2:485-91.

Sivasankari V, Manivannan E, Priyadarsini SP. Drug utilization pattern of anti-diabetic drugs in a rural area of Tamil Nadu, South India - a prospective, observational study. Int J Pharm Bio Sci. 2013;4:514-9.

Kumar KS, Sreeramya G, Krishna KM, Nalini K, Kiranmai N, Vasavi P. Drug use pattern study of antidiabetics in type 2 diabetes mellitus at a tertiary care hospital in Tenali, Andhra Pradesh. Int J Inv Pharm Sci. 2013;1:162-6.

Sutharson L, Hariharan RS, Vamsadhara C. Drug utilization in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003;35:237-40.

Das P, Das BP, Rauniar GP, Roy RK, Sharma SK. Drug utilization pattern and effectiveness analysis in diabetes mellitus at a tertiary care centre in eastern Nepal. Indian Journal of Physiology and Pharmacology. 2011;55:272-80.

Desai NR, Shrank WH, Fischer MA, Avorn J, Liberman JN, Schneeweiss S, et al. Patterns of medication initiation in newly diagnosed diabetes mellitus: quality and cost implications. Am J Med. 2012;125:302-7.

Chiang CW, Chiu HF, Chen CY, Wu HL, Yang CY. Trends in the use of oral antidiabetic drugs by outpatients in Taiwan: 1997-2003. J Clinical Pharmacy Therap. 2006;31:73-82.

Cusi K, Defronzo RA. Metformin: a review of its metabolic effects. Diab Rev. 1998;6:89-131.

Johnson JA, Majumdar SR, Simpson SH, Toth EL. decreased mortality associated with the use of metformin compared with sulfonylurea monotherapy in type 2 diabetes. Diabetes Care. 2002;25:2244-8.

Cook MN, Girman CJ, Stein PP, Alexander CM, Holman RR. Glycemic control continues to de- teriorate after sulfonylureas are added to metformin among patients with type 2 diabetes. Diabetes Care. 2005;28:995-1000.

Laakso M, Letho S. Epidemiology of macrovascular disease in diabetes. Diabetes Reviews. 1997;5:294-315.

Ansari KU, Singh S, Pandey RC. Evaluation of prescribing pattern of doctors for rational medicine therapy. Indian J Pharmacology. 1998;30:43-6.

Bener A, Zirie M, Daghash MH, Alhamaq AO, Daradkeh AA, Rikabi A. Lipids, Lipoprotein (a) profile and hba1c among arabian type 2 diabetic patients. Biomedical Research. 2007;18:97-102.