Factors Influencing Utilization of Different Types of Sulphonylureas Amongst Type 2 Diabetes Patients

INTRODUCTION In Malaysia, majority of diabetes mellitus cases are type 2 diabetes mellitus (T2DM). This is a direct extension from the fact that in 1997, 97 % of all cases of diabetes mellitus are T2DM 1. The oral drugs used for the treatment of T2DM are known as oral hypoglycemic agents (OHAs). The most frequently prescribed OHAs are SUs. In the Malaysian Statistics on Medicine 2004, SUs makes up to more than 60 % of all OHAs prescribed 2. The individual SU agents differs in terms of their cost, tolerability, pharmacokinetic profiles and extrapancreatic effects, thus, it is important to identify factors that influence the prescribing pattern of SUs in order to ensure optimal utilization of the drugs 3. As SUs are widely used for T2DM in Malaysia, appropriate utilization of these agents will lead to better diabetes care to the patients and at the same time ensure a more cost-effective usage of SUs in the country. This is important as the cost burden in diabetes mellitus in 2004 was as high as RM 39 million, where gliclazide alone costed RM 16.5 million in the same year in Malaysia 2. Although foreign data are available for the comparison between the individual SU agents, there are limited studies conducted to evaluate the choice of SUs when making clinical decisions 4. In Malaysia, there is no data on factors that determine the prescribing pattern of SUs. In addition, there are lacks of studies that evaluate the appropriateness of utilization of SUs. Therefore, this study aims to investigate the utilization of different types of SUs among the type 2 diabetics. This retrospective observational study was conducted in the University Malaya Medical Centre (UMMC) in the year 2006. This study consisted of all adult type 2 diabetics who had received or was currently receiving glibenclamide, gliclazide or glipizide.