ANTI-DIABETIC DRUG COMBINATIONS IN TYPE-II DIABETES MELLITUS AND OUTCOME OF PATIENTS’ COMPLIANCE ON FASTING BLOOD GLUCOSE CONTROL
Journal Title: European Journal of Biomedical and Pharmaceutical Sciences - Year 2019, Vol 6, Issue 10
Abstract
Background: Patients’ adherences to medication and other treatment plans is cornerstone toward attaining glycaemic control in type II diabetes mellitus (T2DM). Objectives: The study assessed the effects of patient compliance on fasting glucose change and hence glycaemic control, the extent to which therapy duration influences glycaemic control at various compliances levels, effects of mono-therapy or poly-therapy of diabetic medication on glycaemic control at various compliances level, and effects of compliance status on diabetes symptoms and medication adverse effects. Methods: Glycaemic status is classified as hypoglycaemia, normoglycaemia, impaired glucose concentration and hyperglycaemia. Glycaemic levels are considered as controlled if fasting blood glucose is less than 7.0mmol/dL and uncontrolled if higher. A four-scaled compliance ratings which includes very poor, poor, fair and good were used to determine whether the effects of drug combination, duration of therapy, degree of fasting glucose control and changes in glucose control and other clinical outcome like adverse effects of medication and some diabetic complications were related. Results: Compliances for very poor, poor, fair and good affected 93(21.7%), 106(24.8%), 119(27.8%) and 110(25.7%) patients respectively. Among those in the category of very poor compliance record (n=93), glycaemic control n(%) were hypoglycaemia 2(2.2%), normoglycaemia 7(7.5%), impaired glucose concentration 8(8.6%) and hyperglycaemia 76(81.6%). The corresponding values were 1(0.9%), 11(10.4%), 28(26.4%) and 66(62.3%) respectively for those in the categories of poor compliances; and 4(3.4%), 17(14.3%), 16(13.4%) and 82(68.9%) respectively for fair compliances while these values were 2(1.8%), 40(36.4%), 33(30.0%) and 35(31.8%) respectively for those in good compliances category. There were strong positive correlation coefficients as one moves from very poor compliance to poor compliance to fair compliance and to good compliance rating for all hypoglycaemic (r2=0.8461), normoglycaemic (r2=0.9190), impaired glucose concentration (r2=0.7166) and strong negative correlations for hyperglycaemic (r2= -0.6609) cases respectively suggesting good compliance could have a remarkable influence. Conclusion: Our evaluation indicated that in most cases glycaemic control is not determined by the level of drug combinations since many other factors requiring pharmacist’s intervention through pharmaceutical care were found lacking. Although compliances rating are directly related to glucose control in some instances, such was not the case in others. This study may have indicated the need to identify patients with compliance problems and institute comprehensive effort of medication monitoring, patient education, dietary control, exercise and other lifestyle modification before beneficial outcome of achieving glycaemic control in such patients can be seen.
Authors and Affiliations
Dr. John David Ohieku
Keywords
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