지역병원 외래환자의 경구용 당뇨약제의 처방분석

Abstract

Diabetes Mellitus is metabolic disease characterized by hyperglycemia resulting from the defective secretion of insulin, or decreased sensitivity of peripheral tissues to insulin, or both. Chronic hyperglycemia, if not well controlled, damages eyes, kidneys, nerves and blood vessels of the humans. The etiology and pathophysiology leading to the hyperglycemia, however, differ from greatly among diabetes patients, suggesting different prevention and treatment strategies might be required. Various classes of antidiabetic agents such as sulfonylureas, meglitinide, biguanide, thiazolidinediones and alpha-glucosidase inhibitors have been developed. However, regional difference in the pattern of administration of those drugs against diabetic patients in Gyeongsang Hospital has been never studied yet. This survey was aimed to investigate the prescription patterns of oral antidiabetic agents based on the same efficacy class of drugs in combination with antihypertensives in the outpatients of Gyeongsang Hospital. The prescriptions of 610 outpatients (M/F 315/295) who were administered oral antidiabetics over 28 days at once from January to February in 2006 were reviewed. We found that mono-therapy including only single efficacy class of antidiabetic drugs was the most prefered one as 45.4%, in which sulfonylureas were the most frequently prescribed drugs as 92.1%, and followed by double-combination therapy using two efficacy classes of drug as 39.5%, in which sulfonylurea with alpha-glucosidase inhibitor combinations were the highest as 43.2% and triple-combination therapy administered three efficacy classes of drug as 14.6%, in which sulfonylurea with biguanide and alpha-glucosidase inhibitor combinations were the highest as 62.9%. We also noticed that about 50.2% (M/F 47%/53%) of outpatients taking antidiabetics were prescribed more than one antihypertensives at the same time. Among them, outpatients who were prescribed only single efficacy class of antihypertensive in combination with antidiabetics were 52.6%, in which the most prefered drug was Calcium channel blocker (CCB) as 39.8%, and then outpatients who were prescribed with two and three classes of antihypertensive drugs were 34.3 % and 12.8 %, respectively. These study results would help not only to understand regional characteristics of diabetic patients and prescription patterns but also to select new antidiabetics or the substitutes in this hospital.