Assessing the appropriateness of Metformin prescribing in Diabetes type 2 patients, Inburi Hospital

Main Article Content

Piyawat Rattanapan

Abstract

This retrospective descriptive study aimed to determine the appropriateness of metformin prescribing in diabetic type 2 patients and to study the incidence of metformin-associated lactic acidosis (MALA) in diabetic type 2 patients. This study was conducted by analyzing the data of patients diagnosed with diabetes type 2 (ICD10 disease code E11.0-E11.9) who were treated at Inburi hospital Between October 1, 2021 and September 30, 2022. A total of 2,596 diabetes patients with 10,580 visits were included. Metformin was appropriately prescribed in 96.12% of follow-ups (n=10,169). The incidence of acute renal failure was 0.48% during the study (n=51). In addition, three patients with metformin-associated lactic acidosis (MALA) were found to have a serious adverse reaction with an incidence of 0.03% (n=3) (115.56 cases per 100,000 cases-years receiving metformin).All three patients developed acute kidney injury and one patient received renal replacement therapy. From this data, healthcare professionals should be aware of drug use rationally and guidelines for rational drug use should be established.

Article Details

How to Cite
1.
Rattanapan P. Assessing the appropriateness of Metformin prescribing in Diabetes type 2 patients, Inburi Hospital. JMPH4 [Internet]. 2023 Jun. 29 [cited 2024 Dec. 22];13(2):1-12. Available from: https://he01.tci-thaijo.org/index.php/JMPH4/article/view/261157
Section
Original Articles

References

Department of Disease Control. ACCESS TO DIABETES CARE [Internet]. 2021 [cited 2022 Dec 1]. Available from: https://ddc.moph.go.th/brc/news.php?news=21692&deptcode=brc (in Thai)

Diabetes Association of Thailand. Clinical practice guideline for diabetes 2017. 3 rd ed. Pathum Thani: Romyen Media;2017. (in Thai)

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2023. Diabetes Care 2023 Jan 1;46(1):S140-57.

DeFronzo R, Fleming GA, Chen K, Bicsak TA. Metformin-associated lactic acidosis: Current perspectives on causes and risk. Metabolism 2016;65:20-9.

Bruijstens LA, van Luin M, Buscher-Jungerhans PM, Bosch FH. Reality of severe metformin-induced lactic acidosis in the absence of chronic renal impairment. Neth J Med 2008;66(5):185-90.

Leesumlan W. Metformin-induced metabolic acidosis: Case report. Medical and Health Product Bulletin 2003;6:16-23. (in Thai)

Richy FF, Sabidó-Espin M, Guedes S, Corvino FA, Gottwald-Hostalek U. Incidence of lactic acidosis in patients with type 2 diabetes with and without renal impairment treated with metformin: a retrospective cohort study. Diabetes Care 2014;37:2291-5.

US Food and Drug Administration. FDA drug safety communication: FDA revises warnings regarding use of the diabetes medicine metformin in certain patients with reduced kidney function [Internet]. 2016 [cited 2022 Oct 14]. Available from: https://www.fda.gov/media/96771/download

Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract 2012;120(4):c179-84.

Onngam S. Prescribing Pattern of Metformin in Type 2 Diabetic Patients with Various Estimated Glomerular Filtration Rates (eGFR). Thai Journal of Pharmacy Practice 2021;13(1):175-88. (in Thai)

Thochu S, Muenpa R. Outcomes of the Program on Rational Drug Use Hospital in Nonghong District, Buriram. Thai Journal of Pharmacy Practice 2017;9(2):463-74. (in Thai)

Chayakhun C, Jongtrajul P, Wananukul W, Punnupurot P, Kanjanarat P, Yotsombat K, et al. Rational drug use hospital manual. Bangkok: House of agricultural cooperative federation of Thailand;2015. (in Thai)

Meechumnarn S. Promoting Rational use of Metformin in Diabetic Patients, at Thawatburi Hospital Roi-Et Province. Journal of Research and Health Innovative Development 2022;3(1):241-50. (in Thai)

Panta P, Techakehakij W. The prevalence of and factors associated with inappropriate metformin prescription in type 2 DM patients with contraindications: a case study in Thailand. Region 11 Medical Journal 2019;33(1):131-40. (in Thai)

Ponhiamhan S. The effectiveness of using the protocol for monitoring incidence of Metformin Associated Lactic Acidosis in diabetic mellitus patients at Nakhonphanom Hospital. Nakornphanom Hospital Journal 2021;8(1):52-62. (in Thai)

Kobpungton P, Chueamuangphan N. Associated factors of metformin associated lactic acidosis in diabetic patients at Chiangrai Prachanukroh Hospital. Chiangrai Medical Journal 2020;12(1):44-51. (in Thai)