Type 2 Diabetes Mellitus (T2DM) is one of the most prevalent chronic diseases worldwide, characterized by insulin resistance and relative insulin deficiency. The increasing incidence of T2DM has posed a significant burden on healthcare systems, particularly in developing countries like India. According to global estimates, the number of individuals affected by diabetes is projected to rise substantially due to sedentary lifestyles, obesity, and genetic predisposition (Wild et al., 2004). Effective management of T2DM requires long-term pharmacological intervention along with lifestyle modifications. Drug utilization studies (DUS) play a crucial role in evaluating the prescribing patterns of medications and ensuring rational drug use. The World Health Organization (WHO) defines drug utilization as the marketing, distribution, prescription, and use of drugs in a society, with special emphasis on the resulting medical, social, and economic consequences (WHO, 2003). These studies help identify inappropriate prescribing, polypharmacy, and deviations from standard treatment guidelines, thereby improving patient outcomes. Antidiabetic drugs include a wide range of pharmacological classes such as biguanides, sulfonylureas, thiazolidinediones, DPP-4 inhibitors, and insulin therapy. Among these, metformin is widely recommended as the first-line therapy due to its efficacy, safety, and cost-effectiveness (American Diabetes Association, 2015). However, the choice of therapy often depends on patient-specific factors such as age, duration of disease, comorbidities, and glycemic control. Despite the availability of evidence-based guidelines, irrational prescribing practices still exist, including overuse of combination therapy, inappropriate drug selection, and lack of dose individualization. Therefore, conducting drug utilization studies is essential to monitor prescribing trends and ensure adherence to guidelines. This study aims to evaluate the drug utilization pattern of antidiabetic drugs in patients with T2DM in a tertiary care hospital setting.

This study was designed as a prospective observational study conducted over a period of eight months from September 2020 to April 2021 in the outpatient and inpatient departments of a tertiary care hospital. A total of 200 patients diagnosed with Type 2 Diabetes Mellitus were included in the study. Ethical approval was obtained prior to data collection, and informed consent was taken from all participants. The study involved collecting patient demographic details, clinical characteristics, and prescribed medications using a structured data collection form. Information regarding age, gender, duration of diabetes, comorbidities, and prescribed drugs was recorded. Prescriptions were analyzed for drug class, dosage, frequency, and route of administration. The rationality of prescribing was assessed based on standard treatment guidelines such as those provided by the American Diabetes Association (ADA). Inclusion Criteria • Patients diagnosed with Type 2 Diabetes Mellitus • Patients aged ≥ 30 years • Patients receiving at least one antidiabetic drug • Patients willing to participate Exclusion Criteria • Patients with Type 1 Diabetes Mellitus • Pregnant women • Patients with incomplete medical records • Critically ill patients Data Collection Procedure Data were collected using patient case records and prescription analysis. Each prescription was evaluated for drug utilization indicators such as number of drugs per prescription, percentage of generic prescribing, and use of combination therapy. Statistical Data Analysis Data were analyzed using descriptive statistics. Results were expressed in percentages and mean values. Tables and charts were used to represent findings.

A total of 200 prescriptions were analyzed. The majority of patients were in the age group of 51–60 years (40%), followed by 41–50 years (30%). Male patients (60%) outnumbered female patients (40%). Most patients had a duration of diabetes between 5–10 years. Metformin was the most commonly prescribed drug (85%), followed by sulfonylureas (60%), insulin (25%), and DPP-4 inhibitors (20%). Combination therapy was observed in 65% of patients, while monotherapy was used in 35% of cases. Polypharmacy was observed in patients with comorbid conditions such as hypertension and dyslipidemia. Most prescriptions followed standard guidelines; however, some cases showed early initiation of combination therapy. Tables Table 1: Age Distribution Age Group Number Percentage 30–40 20 10% 41–50 60 30% 51–60 80 40% >60 40 20% Table 2: Gender Distribution Gender Number Percentage Male 120 60% Female 80 40% Table 3: Drug Utilization Pattern Drug Class Frequency Percentage Metformin 170 85% Sulfonylureas 120 60% Insulin 50 25% DPP-4 inhibitors 40 20% Table 4: Therapy Type Type Number Percentage Monotherapy 70 35% Combination Therapy 130 65% Table 5: Comorbidities Condition Percentage Hypertension 55% Dyslipidemia 40% Others 15%

The present study highlights the prescribing patterns of antidiabetic drugs in a tertiary care hospital. The findings indicate that metformin is the most commonly prescribed drug, consistent with previous studies (Nathan et al., 2009; ADA, 2015). This supports its role as the first-line therapy in T2DM management due to its efficacy and safety profile. Combination therapy was observed in a significant proportion of patients (65%), which may be attributed to poor glycemic control or long duration of disease. Similar findings have been reported in earlier studies (UKPDS Group, 1998). However, early initiation of combination therapy in some patients may indicate deviation from standard guidelines. The prevalence of comorbid conditions such as hypertension and dyslipidemia emphasizes the need for comprehensive management of T2DM. Polypharmacy was common in such cases, increasing the risk of drug interactions and adverse effects (Strom, 2000). Overall, prescribing patterns were largely rational, but there is a need for continuous monitoring and education to ensure adherence to guidelines.

This study demonstrates that drug utilization patterns in T2DM patients are generally consistent with standard treatment guidelines. Metformin remains the cornerstone of therapy, and combination therapy is widely used for better glycemic control. The findings suggest rational prescribing practices in most cases. However, there is scope for improvement, particularly in avoiding unnecessary combination therapy and promoting individualized treatment. Regular drug utilization studies are essential to ensure rational prescribing and improve patient outcomes. Future studies with larger sample sizes are recommended.

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