INTRODUCTION:

Diabetes mellitus is a pandemic disease that has struck each and every corner of the world. According to the Indian Council of Medical Research-Indian Diabetes study (ICMR), a national diabetes study, India currently has 62.4 million people with diabetes. This is set to increase to over 100 million by 2030. The prevalence of diabetes among adults has reached approximately 20% in urban and approximately 10% in rural populations in India.

Various classes of anti-diabetic drugs including insulin and oral hypoglycemic agents (OHA) are currently used in the treatment of diabetes, which acts by different mechanisms to reduce the blood-glucose levels to maintain optimal glycemic control.¹

The currently used anti-diabetic drugs are very effective, however because of lack of patient compliance, clinical inertia, insulin resistance, lack of exercise and lack of dietary control leads to unsatisfactory control of hyperglycemia. Currently, there are five distinct classes of hypoglycemic agents available, each class displaying unique pharmacologic properties.² These classes are the sulfonylureas, meglitinides, biguanides, thiazoli dinediones and alpha glucosidase inhibitors. In patients for whom diet and exercise do not provide adequate glucose control, therapy with a single oral agent can be tried. When choosing an agent, it is prudent to consider both patient- and drug-specific characteristics. If adequate blood glucose control is not attained using a single oral agent, a combination of agents with different mechanisms of action may have additive therapeutic effects and result in better glycemic control. If adequate control is not obtained with the use of a single agent, combination therapy is an option. Several of the available oral agents have been studied in combination and have been shown to further improve giycemic control when compared to monotherapy. As with monotherapy, the choice of a second agent should be based on individual characteristics. Reasonable combinations of agents include a sulfonylurea plus metformin, a sulfonylurea plus an alpha- glucosidase inhibitor, a sulfonylurea plus a thiazolidinedione, metformin plus repaglinide, biguanide plus alpha-glucosidase inhibitor, and metformin plus a thiazolidinedione.^3,4

Therefore, this study was carried out to find the current prescribing pattern of anti-diabetic drugs and efficacy of these drugs in maintaining adequate glycemic control in diabetic patients in vategaon region.¹

METHODOLOGY OF SURVEY⁵:

A Home survey was done by visiting individual patients. Patients were ask to give prescription and the names of drug prescribed were noted down by the volunteers. Following information was also noted down.

1) Age

2) Gender

3) Name of drugs (Brand Name and Generic name)

The information so collected was processed as follows-

1) Age wise distribution of patient.

2) Gender wise distribution of patient.

3) Classification of drugs.

4) Combination of drug.

PRESCRIPTIONS HANDLED AND THE DETAILS

Table No 1: Class of Drugs

Code	Class of Drug	Code	Class of Drug
A	Sulfonylureas	E	Biguanide
B	Meglitinide/phenylalanine analogues	F	Thiazolidinediones
C	Glucagon-like peptide-1 (GLP-1) receptor agonists	G	a-Glucosidase inhibitors
D	Dipeptidyl peptidase-4 (DPP-4) inhibitors	H	Amylin analogue

RESULTS AND DISCUSSION:

Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. Patients with high blood sugar will typically experience polyuria (frequent urination), they will become increasingly thirsty (polydipsia) and hungry (polyphagia).Diabetes has been the leading cause of mortality since many. Scientists in the medical field have discovered many new molecules which can be exploited for the treatment of Diabetes. The present study was aimed at assessing the pattern of Diabetes treatment in the village of Vategaon. The prescriptions that came to the pharmacists were assessed In order to study this pattern.^4,6

The study revealed that the incidence of hypertension in female was 20 % while the same for males was 30 %.

Table No 2. Gender wise Patient

Gender	No. Patients
Male	30
Female	20

Figure No 1: Genderwise Distribution Graph

It also showed that the age wise distribution of incidence followed almost normal distribution from the age group 31-40 to 81-90 years with peak incidence in the age group of 61-70 years which is concordant with previous studies made by different scientists.

Table No 3. Age wise Distribution

Age In Years	Number of Patients
31-40	3
41-50	10
51-60	14
61-70	17
71-80	3
81-90	3

Figure No 2 Graph of Age wise distribution of Patients

The physicians prescribed for maximum number of time the Biguanide drugs with a percentage of 94 %. And sulphonylurease of 32% while 6 % was Thiazolidine dione. And 8 % α glucosidase inhibitor.

Table No 4. Classification of Antidiabetic drugs with Prescription

Class of Antidiabetic Drugs	Number of times prescribed
Sulfonylureas	16
Meglitinide/phenylalanine analogues	0
Glucagon-like peptide-1 (GLP-1) receptor agonists	0
Dipeptidyl peptidase-4 (DPP-4) inhibitors	0
Biguanide	47
Thiazolidinediones	3
a-Glucosidase inhibitors	4
Amylin analogue	0

Figure No 3: Graph of Class of Antidiabetic Drugs

The combination of two drugs was prescribed for 16 times and the most preferred combination was of a Sulphonyl urease and Biguinides.

Table No 5. Combination of drugs

Combination Employed	Number of times employed
Sulphonyl urease inhibitor+ Biguinides	16
Sulphonyl urease inhibitor+ Biguinides a-Glucosidase inhibitors	3
Sulphonyl urease inhibitor+ Biguinides+ Thiazolidinediones	3
Sulphonyl urease inhibitor+ Biguinides +α-Glucosidase inhibitors+ Thiazolidinediones	1
Biguinides + α-Glucosidase inhibitors	1

Graph No.4 Graph of Combination of Antidiabetic drugs.

CONCLUSION:

The most popular drugs employed by the physicians to treat diabetes are the Biguanide which have been the part of 94 % of the prescriptions under study. This observation is concordant with the ICMR guidelines for the Antidiabetic treatment. The Biguanide give advantage of reducing the weight which has been beneficial in treating the obese diabetic patients. Biguanide have been followed by the sulphonylureas which were prescribed in 32% prescriptions followed by 6 % was Thiazolidinedione. And then 8 % α glucosidase inhibitor.

REFERENCES:

1. Akshay A. Agarwal, Pradeep R. Jadhav, and Yeshwant A. Deshmukh , Prescribing pattern and efficacy of anti-diabetic drugs in maintaining optimal glycemic levels in diabetic patients, J Basic Clin Pharm. June 2014-August 2014; 5(3): 79–83.

2. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979; 28: 1039–57.

3. World Health Organization. Diabetes Mellitus: Report of a WHO Study Group. Geneva: WHO, 1985.Technical Report Series 727.

4. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20: 1183–97.

5. Indrayani D. Raut, Dipak S. Gumate, Tushar Chavan, Swati Chavan, Survey on anti-hypertensive drugs , IAJPS 2015, Vol 2 (6), 1-4 .

6. K.D. Tripathi, Essential of Medicinal pharmacology, Jatpee brothers medical publishers, new delhi, 7^th edition,2013: 258-281.

Received on 09.11.2016 Modified on 19.12.2016

Res. J. Pharmacology and Pharmacodynamics.2017; 9(1): 10-12.

DOI: 10.5958/2321-5836.2017.00002.7