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6. Conclusion
The cost of diabetes care is high and escalating. Therefore the present study
was aimed to evaluate the prescription patterns and cost of illness of type 2
diabetic patients with specific objectives to determine the trends in prescribing
patterns of anti-diabetic and anti-hypertensive drugs in these patients.

This study was conducted in a tertiary care teaching hospital with data
collection period starting from 2008 to 2010. A total of 2120 patients were
followed up for three years to study the prescription pattern for diabetes and
concurrent illness like hypertension and dyslipidemia. Patient demography
was studied to assess its trend for these three years.
1. Significant finding in the study was male predominance as compared to
female predominance in studies from western countries.
2. Present study showed that the majority of diabetic patients were in the
age group of 41 to 65 years and mean age of study population was
57.8 years resulting in development of diabetic related complications in
most productive years of life, as compared to Western studies where
mean age is around 60 years.
3. Prescription pattern analysis showed that most patients were on mono-
therapy (37% to 43%) followed by combination of two drugs (33% to
39%). Commonest drugs used in mono-therapy were insulin,
sulphonylureas and metformin. The commonest two drug combinations
were metformin with sulfonylureas and metformin with Insulin. There
are no overall changes in prescription pattern by the clinicians during
the three year study period.
4. Hypertension affected more than 50% of diabetic patients. Even here,
males (60 to 62%) are affected to greater extent than females (40 to
38%).
5. Commonest antihypertensive drug used in mono-therapy was CCBs.
Even though current recommendation favors ACEIs and ARBs as the
drug of choice, ACEIs and ARBs were second most prescribed drugs
in our study.
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6. 30% of patients were on statins for lipid lowering. 20% patients

received antiplatelet agents for secondary prevention of cardiovascular
complications.
7. 116DM patients each with and without complications were evaluated
for cost analysis. Total median cost was Rs.22,457/- per patient per
annum for those without complications and Rs.30,634/- per patient per
annum for those with complications. Cost escalated when patients had
renal failure requiring haemodialysis(Rs.1,64,211/-) and cardiac
intervention (Rs.1, 67,875/-.).
8. Our study finding is similar to other studies, where delay in the
diagnosis of diabetes results in higher complications, higher
complications in rural illiterate poor patients when compared to urban
educated counter parts, reaffirming poor accessibility to healthcare for
this section of society.