Changing trends in adoption of Diabetes therapeutic practices in India

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

1. KRISHNA G. SESHADRI, 
2. S. VENKATARAMAN, 
3. MANIKANDAN RM, 
4. DWARAKANATH CS, 
5. BOOCHANDRAN TS, 
6. NARAYANAN NK, 
7. JAYASREE GOPAL, 
8. SHANTHARAM DUVURU, 
9. USHA AYYAGARI, 
10. ANISH BEHL, 
11. APOLLO SUGAR RESEARCH GROUP

+Author Affiliations

Diabetes 2018 Jul; 67(Supplement 1): -.https://doi.org/10.2337/db18-1204-P

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Abstract

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.

Disclosure K.G. Seshadri: None. V. S.: None. M. Rm: None. D. Cs: None. B. Ts: None. N. Nk: None. J. Gopal: None. S. Duvuru: None. U. Ayyagari: None. A. Behl: None.

• © 2018 by the American Diabetes Association.