Pattern of Antidiabetic Drugs Use in a Diabetic Outpatient Clinic of a Tertiary Health Institution in Sokoto, North-western Nigeria

To study the pattern of drug prescription among diabetic patients attending the endocrinology clinic of a tertiary health centre in Nigeria with the aim of evaluating the degree of physicians compliance to current evidence and clinical guidelines. This is a descriptive cross sectional study using case notes for 469 patients with mean age of 46.512.5 years and male: female ratio of 1:1.5. Information of interest including demographic details, indication for drug use, concurrent illness and medications prescribed including dosages were extracted using a pre piloted data collection form. Majority of the patients (90.3%) had type 2 diabetes. The percentages of patients on antidiabetic monotherapy and combination therapy were 24.8 and 75.2, respectively. Of the 348 patients on antidiabetic combination therapy, 293 (84.2%) and 55 (15.8%) were on 2 and 3 drugs, respectively. Overall, metformin was the most frequently prescribed antidiabetic agent (81.9%). However, as monotherapy, metformin was overtaken by insulin as the most frequently utilized (32.2% for insulin versus 29.6% for metformin). Hypertension was the most frequent comorbid condition (43.9%) observed in the study and antihypertensive agents, particularly angiotensin converting enzyme inhibitors (the most commonly prescribed antihypertensive agent) was found to be the most frequently utilized non-antidiabetic drugs. About 38% of the patients having both diabetes and hypertension were on Angiotensin Converting Enzyme Inhibitor (ACEI) /Angiotensin Receptor Blocker (ARB) monotherapy. This study revealed that the pattern of antidiabetic prescription was rational and largely compliant with clinical guidelines. However, antihypertensive agents were found to be underutilized for managing patients with both diabetes and hypertension.