Evaluation of Prescribing Practices of Metformin in Patients with Type-2 Diabetes Mellitus

Objectives: To evaluate the prescribing patterns of metformin in patients with type-2 diabetes mellitus and determine whether they are in accordance with published contraindications and precautions. Methods: Medical records of patients admitted with type-2 diabetes mellitus, who received at least one dose of metformin were identified and enrolled into the study. Patient demographic, clinical and biochemical data pertaining to diabetes and its risk factors were collected and documented. Prescribing patterns of metformin in these patients wereevaluated using the drug chart. All the prescriptions were checked for its accordance with published contraindications and precautions. Prescriptions in patients with type-2 diabetes mellitus were compared to the standard prescribing guidelines as per American Diabetes Association to analyse its compliance with recommended guidelines to determine whether metformin was prescribed to patients possessing any of the risk factors associated with development of lactic acidosis. Results: Metformin was used as the first line therapy in 138 patients with type 2 diabetes mellitus, either as mono-therapy or at some instances in combination with other oral hypoglycaemic agents or insulin. About 56 patients were found to have either one or more absolute contraindications and 113 patients had precautionary conditions, despite which the therapy was continued in about 89.13% of the patients. Conclusion: The prescribing contraindications of metformin were found to be high and hence it is necessary to create awareness regarding contraindications and precautionary conditions regarding metformin among physicians and other health care professionals so as to prevent the incidence ling tern adverse effects like lactic acidosis.