Combination therapy of patients with diabetes in Ukraine: quality of life

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Global Journal of Diabetes, Endocrinology & Metabolic Disorders
Volume 1, Issue 1, June 2020, Pages: 40-49
Received: Mar. 17, 2020; Accepted: Apr. 17, 2020; Published: Apr. 27, 2020

Authors:

Germanyuk Tamara, National Pirogov Memorial Medical University, Ukraine,
Ivko Tanya, National Pirogov Memorial Medical University, Ukraine,

Abstract:

Introduction:
Diabetes mellitus is a chronic disease that reduces the quality of life of patients significantly. For economic evaluation to assess the value for money of medical service used indicator of the quality of life (QOL). The aim of the study was the research on the level of QOL of the patients with type 2 diabetes mellitus (T2DM) before and after treatment with combination therapy.

Keywords: Diabetes Mellitus, Patients with Diabetes, Therapy, Medical Service.

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To citation of this article: Germanyuk Tamara, Combination therapy of patients with diabetes in Ukraine: quality of life, Global Journal of Diabetes, Endocrinology & Metabolic Disorders
Ivko Tanya, Combination therapy of patients with diabetes in Ukraine: quality of life, Global Journal of Diabetes, Endocrinology & Metabolic Disorders

References:

IDF Diabetes atlas, seventh edition, 2015 [electronic resource]: [website]. – Electronic data. – Access: http://www.idf.org/diabetesatlas
2. Maxwell O. Adibe. Cost-Utility Analysis of Pharmaceutical Care Intervention Versus Usual Carein Management of Nigerian Patients with Type 2 Diabetes / Maxwell O.Adibe, CletusN.Aguwa, ChinweV.Ukwe // Value In Health Regional Issues 2013. – №2. – Р.189-198

Methodology:
300 questionnaires to determine the quality of life of patients with T2DM. In-patients were treated in specialized endocrinology clinics of the Podolsky region of Ukraine. The quality of life of patients was determined by visual analogue scale adapted European questionnaire of quality of life. We performed a retrospective analysis of 1792 in-patient’s medical histories, their treatment sheets and frequency analysis of the treatment regimens. Frequency analysis of the used pharmacotherapy regimens for patients with T2DM showed that the leaders among the prescribed regimens of combination therapy were metformin+glimepiride (45% of the prescriptions), metformin+gliclazide (15%) and metformin+glibenclamide (6%). That is why these schemes were chosen for further study. The patients were examined on the following parameters: age, sex, duration of T2DM, body mass index, the average fasting plasma glucose, level of QOL before prescribing treatment and after treatment prescribed therapy. All patients were treated with oral antidiabetic drugs only. The patient’s QOL was determined by visual analogue scale adapted European questionnaire EuroQol-5D.

Results:

It was found that age of patients ranged from 20 to 67 years: 20-30 – 6 % (18 patients), 30-40 – 11% (33 patients), 40-50 – 26% (78 patients), 50-60 – 37% (111 patients), 60-67 – 20% (60 patients). Among the patients, women accounted for 52% (156 patients), men – 48% (144 patients)

It has been found that the age of patients with metformin+glimepiride therapy was 56,86±0,62 years, duration of T2DM of these patients – 6,87±0,34 years, body mass index of them was – 32,97±0,47, their average fasting plasma glucose before treatment was – 10,71±0,19 mmol/l; the level of QOL of these patients before treatment was 0,61±0,11, after treatment – 0,69±0,08.

The age of patients with metformin+gliclazide therapy was 57,68±1,16 years, duration of T2DM of these patients – 7,81±0,75 years, their body mass index was – 31,07±0,65, the average fasting plasma glucose before treatment – 10,32±0,34 mmol/l; the level of QOL of these patients before treatment was 0,55±0,16, after treatment – 0,65±0,07. The age of patients with metformin+ glibenclamide therapy was 59,33±1,81 years, duration of T2DM of these patients – 9,43±1,35 years, their body mass index – 32,03±1,18, the average fasting plasma glucose before treatment – 11,11±0,57 mmol/l; the level of QOL of these patients before treatment was 0,46±0,04, after treatment – 0,58±0,13. As a result of the survey by questionnaire it has been found that level of QOL in patients with metformin+glimepiride therapy before treatment was 0,61±0,11, after treatment – 0,69±0,08 (р < 0.05); with metformin+ gliclazide therapy before treatment was 0,55±0,16, after treatment – 0,65±0,07 (р < 0.05); with metformin+glibenclamide therapy was 0,46±0,04, after treatment – 0,58±0,13 (р < 0.05). Also it was determined that the patients with metformin+ glibenclamide regime were significantly older, with the largest T2DM duration, with the highest body mass index and highest levels of fasting plasma glucose. In comparing patients with metformin+gliclazide and metformin+glimepiride treatment regimes it was found no other significant differences (р > 0.05).

Conclusions. According to the results of this study, it has been shown that the greatest value of QOL was in patients with metformin+glimepiride therapy, the lowest – with metformin+gliclazide and metformin+glimepiride therapy. It has been found improving patient’s QOL after treatment by all including in the study regimes.