Evaluation of early postoperative period results of patients with type 2 diabetes taking oral anti-diabetics or insulin medications, with microalbuminuria and normal creatinine levels after coronary artery bypass.

Introduction: In this study, we aimed to compare the early postoperative period results of type 2 diabetes patients taking oral antidiabetics or insulin medications, with microalbuminuria and normal creatinine levels after coronary artery bypass. Materials and methods: Eighty patients with type 2 diabetes and taking oral antidiabetics or receiving insulin medication all with normal creatinine levels with microalbuminuria were included in this study. Preoperative creatinine values of the patients, albumin levels in spot urine, creatinine levels on the postoperative 3rd day, duration of ventilation, amount of drainage, length of stay in the intensive care unit, length of stay in the hospital, mediastinitis and mortality rates were recorded. Results: A statistically significant increase in creatinine was found in both taking oral antidiabetics type 2 diabetes and insulin medication patient groups with microalbuminuria. When the two groups were compared with each other, increase in creatinine levels of the patients using insulin was higher than the patients taking oral antidiabetics, and was statistically significant. Conclusion: According to the result of our study it can be suggested that postoperative creatinine elevation is observed in patients with type 2 diabetes mellitus with microalbuminuria and with normal creatinine levels, either having insulin medication or not. The elevation is higher in patients having insulin medication while other results are similar, except for impaired renal function. Keywords: Type 2 diabetes mellitus, insulin, microalbuminuria, coronary artery bypass.

Potential Drug Interactions Of Oral Antidiabetic In Prescriptions Of Type 2 Diabetes Mellitus Patients At Kumpulan Pane Hospital

Diabetes Mellitus is a disease that can cause complications of other diseases so that the treatment to be given becomes more and this has the potential for interactions between drugs that can affect the physiological condition of the patient. The aim of this study is to analyze the potential of oral antidiabetic interactions on prescription at Kumpulan Pane Hospital. Analysis of potential oral antidiabetic interactions on a prescription using quantitative research methods is retrospective descriptive. Prescriptions used are inpatient and outpatient prescriptions for the period January-December 2020 that get oral antidiabetics. Analyze data using Medscape and Drugs.com sites. Based on analysis of 9.818 prescription sheets of diabetes mellitus patients, there were found 6.454 (65.73%) prescription of potential oral antidiabetic interactions. Potential interaction of an oral antidiabetic group of 10.759 (91.45%) drug, the pattern of interaction mechanisms most often is pharmacodynamic 73.25%. The most common type of oral antidiabetic drugs that have potential interactions is the biguanide group (metformin) 36.76%. The severity of the most frequent interactions was 92.21%. The conclusion of the potential interactions oral antidiabetic are still found in prescriptions that is 65.73% at Kumpulan Pane Hospital. Keyword: Potential Drug Interactions, Oral Antidiabetics, Prescription

ASSESSMENT OF CURRENT PRESCRIBING PATTERN AND COST ANALYSIS OF ORAL ANTI-DIABETIC DRUGS IN ELDERLY POPULATION FROM PUNGANUR REGION OF ANDHRA PRADESH

Objective: The main aim of the study is to analyze the prescribing patterns and cost-effective analysis of single therapy and combination therapy oral anti-diabetic drugs, awareness of patients about diabetes, medication and lifestyle modification in the geriatrics population. Methods: A prospective study was carried out over a period of 12 mo in the region of Punganur Andhra Pradesh. Type 2 diabetic patients who were on oral anti-diabetic drugs were enrolled in the study. A suitable data collection form was prepared and used to collect the required data. The demographic data, disease data and the utilization of various oral anti-diabetic agents were analyzed. About 800 patients were enrolled for the study from rural and urban areas in Punganur. Among the study population, 63% (504) were males and 37% (296) were females in the age group of 55 y and above. The majority of patients were from urban areas 70% (560) and 30% (240) were from rural areas. About 78 % of the patients have a history of diabetes more than 10 y and 22% were more than 5 y and less than 10 y. Results: The present study found that type 2diabetes was prevalent in males than females. Results show two anti-diabetic drugs of single drug and fixed dose combination per prescription was more than the single anti-diabetic drug also found new prescription was observed more and cost of treatment was immense when compared to old prescription. Prescription pattern exposed Glibenclamide, Metformin, Glipizide and Glimepiride were the most common drugs used among the various oral antidiabetics. Currently, newer drug DPPi 4 inhibitors like Sitagliptin, Vildagliptin and Teneligliptin are used as single and combination with metformin were increased in prescription. Among the various oral antidiabetics prescribed, the cost of 2 drugs per prescription and newer anti-diabetic drugs like DPPi4 was high but cost analysis study revealed the availability low cost brands in market. Conclusion: The study concluded that Prescription pattern and cost analysis of marketed anti-diabetic drug might be helpful for the professional to prescribe low cost effective medication.

Epidemiology in oral antidiabetic poisoning in children and adolescents – a four-year study in a pediatric poison centre

Oral antidiabetics have become a common etiology associated with acute poisoning in children. The study shall carry out an analysis of the demographic characteristics, circumstantial characteristics and clinical profile associated with oral antidiabetic poisoning. An observational, descriptive and retrospective study was carried out over a period of 4 years including children confirmed with the diagnosis of acute poisoning with oral antidiabetics. In the study group, there is a prevalence of voluntary acute poisoning in female patients in the 15 to 18 year age group. bIn the group study biguanides were the most frequent pharmaceutical dugs involved. The predominant clinical manifestations associated with oral antidiabetic intoxications were gastrointestinal.

Clinical outcomes related to fasting plasma glucose variability, history of diabetes mellitus and antidiabetic regimens in patients with atrial fibrillation: a subgroup analysis from the SPORTIF trial

Introduction The role of diabetes mellitus in determining of major adverse outcomes in patients with atrial fibrillation (AF) is well-established. Little is known about fasting plasma glucose (FPG) visit-to-visit variability (VVV) and its impact on outcomes. Aim To analyse the role of FPG-VVV in determining major adverse outcomes in AF patients. Second, to evaluate the prognostic impact of history of diabetes mellitus and antidiabetic regimens. Methods Warfarin-treated patients from the SPORTIF trials were considered for analysis if they had FPG evaluation at baseline and at least 4 determinations throughout follow-up. Standard deviation (SD) of the mean of FPG throughout follow-up was the main measure of VVV, according to its quartiles (SD-Qs). A composite of cardiovascular events and the occurrence of all-cause death was the adverse outcome considered. Results Among the 3665 patients originally included, 3415 (93.2%) were included in this analysis. Throughout a mean (±SD) of 577.59 (±122.09) days of follow-up patients in the highest SD-Q (SD-Q4) had the highest rate of the composite outcome and all-cause death [Figure]. A Cox multi-regression analysis confirmed that SD-Q4 had a significant independent association with occurrence of composite outcome (hazard ratio [HR]: 1.61, 95% confidence interval [CI]: 1.10–2.35) [Figure, Upper Panel], with a non-significant trend for all-cause death, [Figure, Lower Panel]. If no significant impact of history of diabetes mellitus was found, there was a significant impact on the composite outcome of the various antidiabetic regimes: there was no difference found in patients treated with oral antidiabetics, compared to no antidiabetic treatment, but those patients treated with insulin (±oral antidiabetics) were independently associated with the occurrence of composite outcome (HR: 2.38, 95% CI: 1.05–5.38) (Table). Conclusion In AF patients treated with warfarin, patients with the highest FPG-VVV had an increased rate of outcomes and the largest FPG-VVV being significantly associated with the composite outcome of adverse clinical events. In diabetic patients, use of insulin is independently associated with an increased risk of the composite outcome, reflecting the more severe disease in determining adverse events amongst AF patients. Major Adverse Outcomes Funding Acknowledgement Type of funding source: None

Perception of Therapeutic Education in Diabetic Patients at Tit Melil Health Center

Introduction : A chronic condition like diabetes interferes with an individual's well-being, and if some of their needs are not met because of the disease, their quality of life is reduced. In this context, therapeutic education constitutes a basic element in the management of diabetes.Materials and Methods : A cross-sectional study by self-administered questionnaire and interviews which were carried out with all type 1 and type 2 diabetics, consultants at the level of the Tit Mélil Primary Health Care establishment, in 2019 and who benefited from or not therapeutic education, with or without complications.Result : The study included 50 diabetic patients, surveys show us that type 1 diabetic patients were 13 (26%). And type 2.37 (74%). Regarding the organization of care, 74% of patients say they are under treatment with oral antidiabetics, 10% oral antidiabetics and insulins, 6% insulin therapy and others under diet. Speaking of Food, 76.5% of diabetics know the importance and know what foods to avoid.Conclusion : TVE is possible, it will result in a change in the structure of programs and new educational training for caregivers.