Pharmacoepidemiology of Macrovascular and Microvascular Complications in Type 2 Diabetes Mellitus Patients
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Background Work: Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia; is associated with abnormalities in carbohydrates, fat, and protein metabolism; and results in chronic complications including microvascular, macrovascular, and neuropathic disorders. Researchers have shown that as a result of these complications, the quality of life (QOL) of patients with type-2 DM is remarkably lower than the QOL of general population and also somewhat lower than patients with other chronic disease. Most complications are preventable and a key strategy is metabolic control through of diet, exercise, and medication Methodology: This study was a prospective observational study which was conducted over a period of one year among type-2 diabetic patients attended at out-patient department of Diabetes Center the patients were reviewed on daily bases those are within the study inclusion criteria enrolled into study. Collected all relevant information from the patient’s case sheets, laboratory reports, patients care taker, treatment charts and other resources.Calculate the prescribed daily dose and compare it with the Defined Daily Dose. Results and Discussion: Out of 509 patients nearly 324 (63.65%) were associated with macrovascular complications like hypertension, Ischemic heart disease and Hyperlipidemia and 185 (36.34%) were associated with microvascular complications like Neuropathy, Nephropathy and Retinopathy. In 186 hypertensive patients a total of 317 antihypertensive drugs were prescribed. The average use of antihypertensive drugs per prescription was 1.70. For Ischemic Heart Disease Aspirin is often given at higher doses than defined dose as well as clopidogrel. PDD:DDD for aspirin and clopidogrel was 1.66 and 1.33 respectively. The average uses of dyslipidemia drugs per prescription were 1.71. In 185 patients a total 248 microvascular complications were identified. Microvascular complications occur due to the damage of small blood vessels. Damage of nerves due to diabetes is known as diabetic neuropathy 122 (65.94%).Nephropathy, where kidney enlarges in size, which follows the increase in glomerular filtration rate (GFR), but as the disease advances it decreases 78 (42.16%).Losartan were given mostly followed by torsemide and Ramipril. In 122 patients with Neuropathy a total of 375 drugs were prescribed, with an average of 3.07 drugs per prescription and are as follows. Conclusion:This study was conducted to decrease prevalence of disease, through creating awareness about drug treatment and diabetic complications.Among the various complications,macrovascular complications caused major threat and among macrovascular complications, Hyperlipidemia and hypertension are major causes.
Authors and Affiliations
Venkateswarlu Konuru1, T. Rama Mohan Reddy2
Keywords
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