Appropriateness Of Type 2 Diabetes Mellitus Drug Therapy A Case Of Tikur Anbessa Specialized Hospital Diabetes Clinic

Background: Diabetes mellitus (DM) is a metabolic problem involving chronically high bloodrnglucose levels or hyperglycemia, which is thought to arise from insulin deficiency. This insulinrndeficiency can be decrease in amount or a complete absence in body. In the long run high bloodrnglucose level could lead to various complications. Beside altered glucose metabolism carbohydrate,rnprotein, and lipids metabolisms are also affected in diabetes mellitus.rnObjective: To assess appropriateness of Type 2 diabetes mellitus drug therapy (T2DM) andrninvestigate association between fasting blood glucose (FBG) and the patients’ clinical andrndemographic characteristics at the diabetes clinic of Tikur Anbessa specialized hospital (TASH).rnMethods: The study was a cross sectional hospital based survey and used both quantitative andrnqualitative methods. T2DM patients who came for their follow up treatment at the diabetes clinic ofrnTASH over a one month period (April 2013) were used as research participants. Plus key informantrninterview with the help of semi-structured open ended questioner was used focusing on thernexperience and practice physicians within the diabetes clinic regarding medication choice andrnguidelines they use.rnResults: A total of 103 patients enrolled in the survey and the proportion of females (59.2%) wasrnhigher than males (40.8%). The mean age was 52.2 years and most of them live in Addis Ababa.rnWhen it comes to clinical characteristics mean FBG was 155.99 ± 44.32 mg/dl, the difference inrnFBG between male and female was insignificant (P=0.325). Body mass index (BMI) had a meanrnvalue of 26.4± 3.05 kg/m2 and 51.45% of the patients were overweight. Medication wise NPHrn(56.3%), metformin plus glibenclamide (19.4%) and metformin (10.7%) were the most prescribedrndrug therapies. And 3.88% of patients were only on glibenclamide. The association of gender, age,rnBMI and medication used with the FBG levels of patients was not significant with a p value of 0.6,rn0.803, 0.97 and 0.081 respectively. The key informants point out that patient load, physicianrnrotation, lack of guide-line and devices as a reason for inadequacy of treatment.rnConclusions: The treatment of T2DM is appropriate with existing problems. Metformin was thernfirst choice oral medication, while most patients were on NPH. And no single factor was associatedrnwith influencing the FBG of patients.rnKey Words: Type 2 diabetes mellitus, Drug therapyrnAcknowledgments

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