Adherence to ICMR Guidelines for the Management of Type 2 Diabetes Mellitus in a Tertiary Care Hospital

Ajita  Kapur; Harmeet Singh  Rehan; Munish  Sharma; Geetanjali  Sageena

doi:10.18502/jpc.v13i3.20326

Ajita Kapur Department of Pharmacology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospita, New Delhi, India.
Harmeet Singh Rehan Department of Pharmacology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.
Munish Sharma Department of General Surgery, ESI-PGIMSR, ESI Hospital, Basaidarapur, New Delhi, India.
Geetanjali Sageena Indian Council of Medical Research, New Delhi, India.

DOI: https://doi.org/10.18502/jpc.v13i3.20326

Keywords: Type 2 Diabetes Mellitus; Adherence; Guidelines; Prescribing Pattern; Prescription

Abstract

Background: Adherence to type 2 diabetes mellitus (T2DM) guidelines helps achieve glycemic control and minimize complications. This study evaluated the adherence to the Indian Council of Medical Research (ICMR) guidelines for the management of T2DM.

Methods: In this cross-sectional observational study, 250 prescriptions of T2DM were collected to assess their adherence to ICMR guidelines.

Results: The mean HbA1c of the patients was 8.39%. Ideal fasting plasma glucose, postprandial plasma glucose, HbA1c, and blood pressure levels were achieved in 23.2%, 16.4%, 17.2%, and 46.4% of the prescriptions, respectively. Foot care, lifestyle modification, tobacco cessation, and HbA1c advice within the last 6 months were present in 8, 164, 7, and 104 prescriptions, respectively. Eye examination was advised in 44% of the prescriptions. When indicated, initiation or intensification of anti-diabetic drugs, aspirin, and anti-hypertensive drugs was done in 86.8%, 37.4%, and 98% of the prescriptions, respectively.

Conclusion: Adherence was low for glycemic control, foot care advice, initiation of aspirin, and anti-diabetic drugs according to BMI. Guidelines were frequently adhered to for blood pressure control, advice for lifestyle modifications, initiation or intensification of anti-diabetic and anti-hypertensive drugs. The study inferred the need for better adherence to ICMR guidelines, which could be achieved by their periodic revision in light of new research evidence.