BETABLOCKERS' PRESCRIPTION PATTERNS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND CARDIOVASCULAR COMORBIDITIES. (June 2018) - Diaconu, C.
Abstract : Objective: Patients with type 2 diabetes mellitus (T2DM) are often treated with beta-blockers (BB), due to associated arterial hypertension and/or coronary heart disease. The objective of the study was to investigate the prescription of BB in T2DM patients, the type of BB selected and whether the presence of arterial hypertension (AH) or coronary heart disease influenced the BB choice. Design and method: We conducted a retrospective study of T2DM cases hospitalized in 2 tertiary hospitals from Romania. Diagnostic codes of discharge diagnoses were used to identify eligible patients and to retrieve their data from medical records. Results: We included 221 T2DM patients (52.49% female, mean age 68.7 years, range 37–93 years). In total, 155 patients (70.14%) received beta-blockers. Metoprolol was the medication of choice in 85 cases (38.46%), followed by carvedilol (29 cases, 13.12%), bisoprolol (19 cases, 8.60%), and nebivolol (17 cases, 7.69%). Betaxolol and propranolol were prescribed in one case each (0.45%) and in three cases the choice of BB was undetermined. Of the study group, 180 patients suffered from arterial hypertension (81.45%): grade I = 3 cases (1.36%), grade 2 = 53 cases (23.99%), grade 3 = 113 cases (51.13%), and unspecified = 11 cases. Beta-blockers were prescribed in 126 patients with arterial hypertension (70.00%). Metoprolol was the medication of choice in 69 cases (54.76%), followed by carvedilol (18 cases, 14.29%), bisoprolol (17 cases, 13.49%), and nebivolol (17 cases, 13.49%). In three cases, the choice of BB was unspecified and propranolol/betaxolol were prescribed in one case each. Coronary heart disease was found in 104 patients (47.06%), out of which 81 patients (77.88%) received BB. Metoprolol was the medication of choice in 44 cases (54.32%), followed by carvedilol (17 cases, 20.99%), bisoprolol (11 cases, 13.58%), and nebivolol (8 cases, 9.88%). In one case, the choice of BB was unspecified. Conclusions: In our study group, 70.14% of patients with T2DM received beta-blockers. Nonselective agents were far less used (19.35%) than beta 1-selective antagonists (80.65%). We found no significant differences between the prescription patterns of patients that associated arterial hypertension or CHD and the general group.