Monitoring And Safety Analysis Of Drug Use In Hospitalized Patients With Diabetes

Diabetes is a group of chronic metabolic disorders characterized by abnormally high levels of glucose in the blood. Microvascular and Macrovascular Complications of Diabetes Mellitus constantly increase as the disease progresses, and so that the mortality and morbidity of the disease. Currently the most effective treatment for patients with diagnosed diabetes is drugs hypoglycemic therapy. The patients require long-term even lifelong medication and a combination of hypoglycemic agents during the different stages of the disease. Therefore, it is inevitably that there will be adverse drug reactions during the medication.In this study, literature were collected and analyzed based on real-world research. Cinical pharmacists of the Department of Endocrinology participate in medical rounds and pharmacy rounds daily, and monitor the hypoglycemic drugs among impatients with diabetes.By collecting drug use and adverse reaction data in diabetes patients hospitalized in endocrinology wards, perform comprehensive analysis and evaluation, and investigate rationality of drug use and relevant factors influencing adverse reactions, so as to provide reference for rational drug use in clinical practice, as well as valuable reference data for training of health care professionals in endocrinology department and evidence-based medicine, finally improving treatment of diabetes in our country, improving diabetes patients’ life quality and saving medical cost. In this article, Microsoft Excel spreadsheet statistics were used to collect drug use data in diabetes patients hospitalized in endocrinology wards. The patients’general information, disease course, duration of hospital stay and medications used were summarized. SPSS17.0software was used for data processing. Measurement data were expressed as x±s and analysis of variance was used. For categorical data, chi-square test was performed. P value<0.05was considered significant. Descriptive statistical analysis and non-conditional logistic regression model analysis were used to analyze adverse drug reactions (ADR) of blood glucose lowering drugs, age, sex distribution, disease course of diabetes, and accumulated drug dose. Common influencing factors of ADR and the impact of drug-drug interaction on ADR were investigated.Data were collected from totally566patients hospitalized in endocrinology wards in PLA General Hospital in2011. In total,3,635drugs were used,6.4±2.5drugs per person at average. Among them, there were1,578glucose lowering drugs,2.8±1.1drugs per person at average. The most commonly used drug was insulin, mainly basal insulin and pre-mixed insulin (accounting for65.2%of used insulin); followed by biguanides, with dose controlled in rational range, and the maximum dose used in a few patients (5.2%).The proportion of two-drug combination therapy was the highest, followed by three-drug combination and monotherapy, in116cases. In two-drug combination therapy, the most common combination was insulin+metformin, followed by insulin+glucosidase inhibitor. In three-drug combination therapy, the most common combination was insulin+metformin+glucosidase inhibitor.Concerning adverse reactions, in monotherapy, insulin and metformin ranked the first and second respectively. In two-drug combination therapy, insulin+metformin had the most adverse reactions, followed by insulin+α glucosidase inhibitor. In three-drug combination therapy, insulin+metformin+α glucosidase inhibitor had the most adverse reactions, followed by insulin+metformin+sulphanylurea. The incidence of adverse reactions in diabetes patients was high (37.1%). Factors influencing occurrence of adverse reactions included age, body weight, number of glucose lowering drugs and sex.Use of blood glucose lowering drugs in diabetes patients hospitalized in endocrinology wards in our hospital was relatively rational. However, there were also some problems. Deeper understanding of clinical practice can not only promote safe, economic, rational and effective use of drugs, but also facilitate timely discovery and early treatment of adverse reactions, reducing the harms caused by adverse reactions.