Polypharmacy in people with Type 1 and Type 2 diabetes is justified by current guidelines--a comprehensive assessment of drug prescriptions in patients needing inpatient treatment for diabetes-associated problems

Diabet Med. 2014 Sep;31(9):1078-85. doi: 10.1111/dme.12497. Epub 2014 Jun 11.

Abstract

Aims: Our aim was to assess the number of medications prescribed to people with Type 1 or Type 2 diabetes mellitus and to compare these to recommendations by guidelines.

Patients and methods: Data from 155 and 154 people with Type 1 and Type 2 diabetes, respectively, were analysed. Prescribed medications (glucose-lowering drugs, blood pressure medications, drugs to treat cardiovascular risk or diseases, etc.) were counted as compounds per day, tablets per day, injections per day, or other modes of administration.

Results: People with Type 2 diabetes were prescribed 8.4 ± 3.0 different drug compounds per day (maximum, 16), 8.6 ± 3.9 tablets per day (maximum, 22), 2.6 ± 1.6 injections per day (maximum, 7), in total 11.6 ± 4.5 doses of any medication per day (maximum, 27). The numbers for people with Type 1 diabetes were 5.5 ± 3.4 compounds per day (maximum, 15), 4.5 ± 4.3 tablets per day (maximum, 18), 3.9 ± 2.2 injections per day (maximum, 8), in total 8.5 ± 5.1 doses of any medication per day (maximum, 22). Over 97% of the prescriptions corresponded to recommendations by guidelines.

Conclusions: The number of prescribed drugs is high in people with diabetes mellitus, and higher for those with Type 2 than with Type 1 diabetes. The compatibility of prescriptions with guideline recommendations suggests that even this high number of prescriptions will provide a clinical benefit. The current analysis could provide a basis for a realistic judgement of the burden imposed by polypharmacy in people with diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticholesteremic Agents / administration & dosage
  • Antihypertensive Agents / administration & dosage
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / prevention & control
  • Diabetes Complications / drug therapy*
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Drug Prescriptions* / statistics & numerical data
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Male
  • Medication Adherence / statistics & numerical data
  • Polypharmacy*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Risk Factors

Substances

  • Anticholesteremic Agents
  • Antihypertensive Agents
  • Hypoglycemic Agents