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The Profile of Blood Sugar Level of Type 2 Diabetes Mellitus and Hyperlipidemia Patients Who Consume Oral Anti-Diabetic Drugs and Simvastatin in Some Community Health Centers in Makassar City

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International Journal of Research and Scientific Innovation (IJRSI) | Volume VII, Issue XII, December 2020 | ISSN 2321–2705

The Profile of Blood Sugar Level of Type 2 Diabetes Mellitus and Hyperlipidemia Patients Who Consume Oral Anti-Diabetic Drugs and Simvastatin in Some Community Health Centers in Makassar City

Rosliah1*, Elly Wahyudi2, Hasyim Kasim3
1Clinical Pharmacy Study Program Hasanuddin University
2,3 Pharmacy Faculty Hasanuddin University

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Abstract
Metformin and glimepiride are oral anti-diabetic drugs used by diabetes mellitus patients, which aims to lower blood sugar levels, while simvastatin is an anti-hyperlipidemia drug with indications of lowering lipid levels in the blood. This study aims to determine the fasting blood sugar level during the use of a combination of oral anti-diabetic drugs and simvastatin drug fortype 2 diabetes mellitus and hyperlipidemia patients in some Community Health Centers in Makassar City. This research is a descriptive non-experimental study with a treatment of data in a population of all type 2 diabetes mellitus and hyperlipidemia patients who consume oral anti-diabetic drugs and simvastatin. Data collection was conducted for a month, namely from January to February 2020, using medical record data and laboratory results of fasting blood sugar test. The research subjects consisted of 3 groups, namely metformin users (n = 39), glimepiride users (n = 13), and a combination of metformin and glimepiride users (n = 28).Changes in fasting blood sugar levels between metformin group, glimepiride group, and a combination of metformin and glimepiride group showed that during 3-month use of a combination of metformin and glimepiride, it was shown significant results (P = 0.017). This indicates that the use of a combination of metformin and glimepiride drugs is better at lowering the patients’ blood sugar level than those of a single therapy of either metformin or glimepiride. The tests were conducted to compare each group of drugs through observations in each month, and the results showed no significant difference. Thus, it can be concluded that there is no difference in any group of treatment.
Keywords: Diabetes Mellitus, Glimepiride, Hyperlipidemia, Metformin, Simvastatin

INTRODUCTION

According to a survey conducted by WHO (World Health Organization), Indonesia is in the fourth position with the largest number of Diabetes Mellitus patients in the world after India, China, and the United States. Its prevalence is 8.6% of the total population. In 1995, the number of Diabetes Mellitus patient was the largest among all diseases caused by endocrine disorders, which was estimated up to 4.5 million people, both hospitalized and outpatient (Department of Health of the Republic of Indonesia, 2005).
Diabetes Mellitus is a disease caused by an effect of insulin secretion, insulin action, or both. Diabetes Mellitus leads to long-term health problems, including dysfunction and failure of various organs like the heart, nervous system, eyes, kidneys, and blood vessels (American Diabetes Association, 2013).
The main cause of death in Diabetes Mellitus patients is the onset of cardiovascular disease. Many risk factors of cardiovascular disease in Diabetes Mellitus patients, namely hypertension, obesity, hyperlipidemia, microalbuminuria, coagulation disorders, stroke, and myocardial infarction (Soegondo S, 2008).
Hyperlipidemia means there is excessive accumulation of one or more main lipids in plasma as a manifestation of metabolic disorders or lipid transport. In clinical expression, hyperlipidemia is referred to as hypercholesterolemia, hypertriglyceridemia, or a combination of both. Secondary hyperlipidemia is caused by increased blood lipid levels due to certain disease, such as Diabetes Mellitus (Arif, et al, 2000).
One of the supporting successes of type 2 Diabetes Mellitus and Hyperlipidemia therapy is by choosing the right drug, while the failure of therapy can be caused by Drug Related Problems. Drug Related Problems (DRPs) are problems that may occur while a patient is receiving a therapy, namely indication without drugs that leads to drug interaction, and the failure of patients to receive therapy due to various factors (Andrianiet al, 2019) .
During observations in several studies, there are different combinations of prescription for diabetes and hyperlipidemia treatments due to differences in the patients’ medical condition and their level of adherence. In terms of the use of drug combination, it is essential to pay attention to the effects of mixing different drugs and its interaction (Gunawan, 2007).
There is a research on the use of statin class drugs increasing fasting blood sugar level in type 2 Diabetes Mellitus patients. In that research, it is found that the fasting blood sugar levels of type 2 Diabetes Mellitus and hyperlipidemia patients decrease after oral anti-diabetic drugs administration. However, their fasting blood sugar levels increase after they are given statin drugs (Bharti 2015, Yeni Farida, 2016).