Type 2 diabetes mellitus’s decompensated form: on the problem of effective pharmacotherapy in real clinical practice

The aim of this retrospective study was to analyze the pharmacotherapy regimens of the decompensated form of type 2 diabetes mellitus (DM2) and to evaluate its effectiveness, its compliance with clinical recommendations.

Materials and methods. A retrospective analysis of 54 medical cards of patients with decompensated DM2 was conducted. The 1^st group (n=24; 44%) included the patients who had a decrease in glycated hemoglobin (HbA1c) by 50% or more in 3 months after hypoglycemic therapy; and the 2^nd group (n=30; 56%) – the patients whose HbA1c level decreased by less than 50%.

Results. A HbA1c level was 10.4% in the 1^st group and 13.2% in the 2^nd group (р<0.001). However, the target levels of venous blood plasma glucose and HbA1c were not achieved in any of the patient groups. The total number of the drugs prescribed to the patients ranged from 4 (in 25% (n=6) and 10% (n=3) cases in the 1^st and the 2^nd groups, respectively) to 8 (in 12.5% (n=3) and 20% (n=6) cases in the 1^st and the 2^nd, groups, respectively). However, in a number of cases some violations of clinical recommendations were recorded: the prescription to the obese patients of insulin drugs, the administration of sulfonylureas derivatives to patients with a history of cardiovascular diseases of the atherosclerotic origin, but modern hypoglycemic drugs with proven benefits in reducing cardiovascular risks were rarely prescribed.

Conclusion. The tactics of pharmacotherapy in the patients with a decompensated form of DM2 does not fully comply with the approved clinical guidelines, which requires the effectiveness of treatment optimization of this medically and socially significant pathology.