Prescribing Pattern of Metformin in Type 2 Diabetic Patients with Various Estimated Glomerular Filtration Rates (eGFR)
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Abstract
Objective: To study prescribing pattern of metformin in type 2 diabetic patients with various estimates glomerular filtration rate (eGFR). Methods: The research was a retrospective descriptive study in patients with type 2 diabetes receiving metformin between July 1, 2017 and June 30, 2019 at Lat Yao Hospital, Nakhon Sawan. The study collected the following data: gender, age, comorbidity, creatinine levels, eGFR, fasting blood sugar, hemoglobin A1c, daily dose of metformin and the occurrence of lactic acidosis. Total number of visit with metformin prescribing and the measurement of eGFR was 5,480 in 2,115 patients. Results: The prescriptions of metformin with doses appropriate to patients’ renal function were accounted for 87.01% of total visits. In patients with eGFR ≥90 mL/min/1.73m2 (CKD stage 1 with recommended dose of not more than 2,550 mg/day), the appropriate dose was prescribed in 87.96% of visits. In patients with eGFR between 60-<90 mL/ min/1.73m2 (CKD stage 2 with recommended dose of not more than 2,550 mg/day), the appropriate dose was prescribed in 92.44% of visits. In patients with eGFR 45-<60 mL/min/1.73m2 (CKD stage 3A with recommended dose of not more than 2,000 mg/day), the appropriate dose was prescribed in 86.62% of visits. In patients with eGFR 30-<45 mL/ min/1.73m2 (CKD stage 3b with recommended dose of not more than 1,000 mg/day), the appropriate dose was prescribed in 64.79% of visits. In patients with eGFR 15-<30 mL/min/1.73m2 (CKD stage 4 with metformin as contraindication), some of them received metformin. In patients with eGFR <15 mL/min/ 1.73m2 (CKD stage 5 with metformin as contraindication), no metformin were prescribed to all 5 patients in this group (100.00% appropriate). This study found 1 patient with lactic acidosis in 1 visit. Conclusion: The dosage of metformin should be adjusted for patients with renal function changes.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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