Assessment of Prevalence, Determinants and Management of Potential Antidiabetic Drug Interactions Altering Glycemic Control in Patients with Type II Diabetes Mellitus-A Cross-Sectional Analysis

Abstract

Patients diagnosed with type II diabetes mellitus are often prescribed multiple medications to achieve glycemic target and to treat the co-morbidities. In these patients, polypharmacy eventually leads to potential drug-drug interactions (pDDI) and adverse outcomes. The study aimed to assess the prevalence of pDDIs altering glycemic control, its determinants, and its management. A cross-sectional investigation was carried out using the medical records of individuals diagnosed with type II diabetes mellitus. Demographic characteristics, medical history, and medications prescribed were obtained from the patient records. The Lexi-Interact® online database was utilised to identify the pDDI. Out of the 101 diabetic patients included, 68% of patients had at least 1 pDDI. A total of 375 drug-drug interactions and 107 pairs of interacting drugs altering the glycemic control were identified. 71.9% drug-drug interaction could lead to hypoglycemic episodes, and 28% drug-drug interaction could cause hyperglycemia-like symptoms. Most of the interactions were moderate interactions (89%) belonging to category C, followed by minor interactions (11%). The antidiabetic drug with the maximum number of interactions was metformin (51%). Female patients, presence of co-morbidities, duration of hospitalisation, and medication count per patient were found to have significant associations with the occurrence of pDDI. Screening of prescriptions by a clinical pharmacist can guide the physicians on avoiding drug combinations causing adverse outcomes in diabetic patients.