Patterns of antidiabetic medication use among inpatients with type 2 diabetes mellitus and impaired renal function at Can Tho Central General Hospital in 2024

Doi: https://doi.org/10.55522/ijti.v4i3.0155

Abstract

Type 2 diabetes mellitus is a common chronic metabolic disorder and is frequently complicated by impaired renal function. In patients with renal impairment, the use of antidiabetic medications requires careful consideration because reduced kidney function may limit the use of several oral glucose-lowering agents and increase the risk of adverse events. Evaluating real-world antidiabetic medication use in this population is necessary to support appropriate clinical management. This study aimed to determine the proportions of antidiabetic medications used among inpatients with type 2 diabetes mellitus and impaired renal function at Can Tho Central General Hospital in 2024. A retrospective cross-sectional study was conducted using medical records of patients with type 2 diabetes mellitus and renal impairment treated at the Nephrology and Endocrinology Departments of Can Tho Central General Hospital from January to August 2024. A total of 310 eligible medical records were included. Data on demographic characteristics, comorbidities, renal disease status, antidiabetic medication groups, insulin types, and active ingredients were extracted and analyzed using descriptive statistics. Among 310 patients, most were aged ≥60 years (68.4%), female (70.6%), and mainly homemakers (35.5%) or retired individuals (29.0%). Chronic kidney disease accounted for 95.8% of cases, whereas acute kidney disease accounted for 4.2%. Among patients with chronic kidney disease, stage 5 was the most common stage (60.9%), followed by stage 4 (22.2%), stage 3 (12.8%), and stage 2 (4.0%). Regarding antidiabetic medication use, insulin was prescribed in 309 patients (99.7%), while metformin was used in only one patient (0.3%). Among insulin users, rapid- or short-acting insulin was the most frequently used type (54.4%), followed by long-acting insulin (26.2%) and premixed insulin (19.4%). Human insulin 1000 IU/10 mL was the most commonly used active ingredient (42.1%), followed by insulin glargine 100 IU/mL (26.2%). Rapid- or short-acting insulin was the most common insulin type in both chronic kidney disease and acute kidney disease groups. Among chronic kidney disease patients, its use increased from 33.3% in stage 2 to 56.9% in stage 5. Insulin was the dominant antidiabetic medication used among inpatients with type 2 diabetes mellitus and impaired renal function, while metformin use was very limited. Rapid- or short-acting insulin was the most commonly prescribed insulin type, particularly among patients with advanced chronic kidney disease. These findings emphasize the importance of individualized antidiabetic therapy in patients with renal impairment.