Evaluation of efficacy of treatment of patients with diabetes mellitus type 2 with the use of different treatment schemes

Aim. To study pharmaco-epidemiological features of hypoglycemic treatment combinations in patients with diabetes mellitus type 2.

Methods. Cross-sectional epidemiologic study included 528 patients who responded the questions from ARIC questionnaire about the scheme of conducted antidiabetic treatment. Glycemia <7 mmol/l was estimated as normal, and glycated hemoglobin ≥7% - as decompensation.

Results. Mono- and combined treatment was received by 94.3% of patients. In treatment tactics there were no statistically significant gender differences. 3% of patients followed only diet therapy, 4.5% received metformin monotherapy, 23.7% took sulfonylureas. 50.8% of patients received insulin monotherapy, 49.2% received 2 insulin medications. In patients receiving metformin, sulfonylureas, insulin and combined therapy glycemia was higher, than in naive patients (7.7%, p <0.05; 8.8%, p <0.05; 17.7%, p <0.01 and 9.8%, p <0.01, respectively), and there were no statistically significant differences in glycohemoglobin levels. 75.3% were administered dual therapy, 22.4% - triple therapy, 2.7% - quaternary therapy. In 93.9% of cases with dual therapy and in 69.4% with triple therapy the tretment was rational. On different schemes of hypoglycaemic treatment adequate control of diabetes mellitus was not achieved in most patients.

Conclusion. Although 97.3% of patients with diabetes type 2 received treatment, in 81% of them decompensation was revealed; to correctly manage the disease doctors should follow international guidelines, widely use new generations of antidiabetics and rational combinations, and to improve adherence of patients to treatment, improvement of work of diabetic schools is recommended.