Original Articles REASONS OF NON-COMPLIANCE TO METFORMIN AMONG TYPE 2 DIABETICS ATTENDING DIABETIC CLINIC IN LAHORE.

Abstract

Objective:

To identify the factors associated with non-compliance to metformin therapy in patients with type 2 diabetes mellitus.

Method:

This was a cross-sectional study, carried out at Jinnah-Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE) Lahore from April 2018 to June 2018. In this study newly diagnosed type 2 diabetic patients were given metformin for the duration of three months and their compliance was observed over that period. Metformin was given starting with low dose of 500mg once daily and then after two weeks was titrated to optimum dose of 500mg twice daily and maximum dose range of 1500-2000mg per day. Multiple factors contributed to patient’s fall out including co-morbidities, shifting to alternative medicine and insulin and GIT intolerance. Blood sampling for A1C estimation was done by A1C analyzer (TD4611A TAI Doc). Research data was collected by questionnaires and patients were called up for follow-up through telephonic communication.

Results:

Out of 260 patients, 200 continued their trial smoothly on metformin while 23% (n=60) were dropped out of the study. GIT intolerance contributed to the major reasons of discontinuing the drug accounting for 35% (n=21) of the patients. Other reasons for non-compliance included change of therapy to insulin (12%) due to uncontrolled raised glucose levels and alternative medicine (5%) by their own decision, deranged LFTs (10%) and RFTs (7%), refusal to the therapy (7%) and various domestic issues (10%).

Conclusion:

Though metformin is the first line drug for treating type 2 diabetes mellitus (T2DM) but GIT intolerance to metformin is one of the major reasons that some patients are unable to tolerate the drug at all.