Antidiabetes Drug Prescription in Indian Scenario—A Cross-Sectional Analysis from a Large, Pan India Database of the Apollo Sugar Clinics

• Published in: Diabetes (New York, N.Y.) Vol. 67; no. Supplement_1
• Main Authors: SESHADRI, KRISHNA G., VENKATARAMAN, S., RM, MANIKANDAN, CS, DWARAKANATH, TS, BOOCHANDRAN, NK, NARAYANAN, GOPAL, JAYASREE, DUVURU, SHANTHARAM, AYYAGARI, USHA, BEHL, ANISH
• Format: Journal Article
• Language: English
• Published: 01-07-2018
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db18-1204-P

Aim: Our objective was to determine nature of antidiabetes prescriptions across the Apollo Sugar Ecosystem, India, a healthcare organization with more than 30 centres (as standalones, secondary and tertiary institutions) that provide care to patients with diabetes
Methods: An eligible 206prescriptions with a diagnosis of T2DM from Jan 2016 to June 2017 were included in this analysis to determine the choice of therapy, frequency of usage of different class of anti-iabetes medications, types of insulin, combination and of number of OHAs with insulin. Descriptive analysis was used to report the results.
Results: The mean age of the patients was 53.2 years, 63% males and 37% females. The majority of the patients were on OHAs (68.2%) with 22.8% of patients on OHAs+insulin and 9.0% on insulin alone. Biguanides (55.7%) were most commonly prescribed in combination with other OHAs followed by DPP-4 inhibitors (DPP-4i) (35%). 63% of patients requiring insulin were using at least one oral drug. The most common drugs used along with insulin included biguanides (50.5%) followed by DPP-4i (46.7%). Among Insulins short acting insulin was most commonly prescribed followed by Insulin glargine (22.5%) and premixed insulin and analogues (13.55).
Conclusions: Several observations stand out from this large cross sectional analysis. 1 A significant number of patients are on monotherapies other than MF. 2. Use of DPP-4i as the most common drug after MF when two drugs are used reflects a significant shift from a SU dominated practice system in India. 3. SGLT2i and insulin find progressive inclusion when three or more drugs are required. 4. A greater adoption of basal and short acting insulin as opposed to premix insulin in a country that was traditionally considered a premix market. The data provided here give a snap shot of the changing trends in adoption of therapeutic practices with availability of newer medications, physician education and patient ability to afford care.