| Objective and Background Diabetes mellitus(DM) is a common and frequently encountered disease which has a higher prevalence among people . Its chronic complications has been the third cause of death following cancer and cardiovascular diseases. DM especially 2-DM is becoming the main severe public health problem effecting the physical and mental health of mankind. Large clinical data reveal the common effect resulting from bad control of plasma glucose and pathological change relative aging further accelerate the onset of diabetic complication. So it is important to choose reasonable antidiabetic drugs and strengthen the treatment for DM. There already have many reports about the Pharmacoepidemiology on DM in internal and overseas.But we have not seen the report about DM in Shangjie Zhengzhou. So the aims of the study are to know the state of utilization and the influencing factors of antidiabetic drugs in DM in Shangjie.To realize the aims above, we develop the pharmacoepidemiological study of diabetic drugs.Methods The 1209 cases of Diabetes mellitus (DM) were collected in our district, which all were diagnosised DM by hospital .Then the cases were investigated and paid a return visit by questionnaire .As a result,the retrieve of DM questionnaire was 1001 cases in this study.The results was managed by statistical treatment.Results (1)We managed a drug monitor system in DM population,which fit to the study of pharmacoepidemiology. (2) The number of under supervision of a physician was 423 cases(42%),taking medicine regularly was 355 cases (35%);the number of taking drugs (≥9months) was 776 cases including those who did not take doctor's orders.The whole ration of the FPG effective controlled was 82%. (3) The antidiabetic drugs in community population had 7 categories including 65 kinds.The number of taking more than two kinds of drugs was 719 cases.The number of taking the traditioanal Chincese medicine was 964 cases(43%),the number of the Metformin(MET) was 572 cases (26%),the following was the insulin(272 cases, 12%).The antidiabetic herbs had 10 kinds ,the most number of that was Xiaoke Pills. (4)The number of one drug monotherapy was 706 cases, the manner of two drugs combotherapy had 58 kinds 277 cases,that of three drugs was 12 (18 cases). It showed SU and MET combotherapy was dominant in community DM including the Tolbtamide and the Phenformin which were the first genration of that drugs and had more serious adverse reaction. It also showed the combotherapy of the same kind of drug ,which less reasonable.The number of Ins group including the combining of OHA was 253 cases(25.27%),which had higer FPG (fasting plasma glucose) controlled ratio (83%). (5)The FPG(fasting plasma glucose) was the only one as a measure of long-term blood glucose control > and the detection of HbA1c was not developed in our community.Conclusion (1) The ratio of taking medicine regularly and compliance was low but the FPG controlled ratio was not low ,it showed that the glycaemic controlled state was the chief consideration standard when the diabetic were choicing the antidiabetic.(2) The kinds of drugs and the frequency of changing drugs in this community DM were very high , and the ratio of the traditioanal Chincese medicine was dominated.The choice of drugs and the change of drugs were less consideration and reasonable.(3) The begining of using Ins was later, which should be as early as possible.(4)The ratio of pervasion and using of new drugs were low.(5) The combotherapy of drugs was less reasonable,which aggraved the drug side effect. (6)The important effect of HbA1c in the therapy of DM was not acknowledged . The FPG was the only measure of blood glucose and the development of HbA1c was not began, which was not beneficial to the global assessment of blood glucose in DM. |
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