Perspectives in Clinical Research

LETTER TO EDITOR
Year
: 2018  |  Volume : 9  |  Issue : 2  |  Page : 107--108

Antidiabetic medication and quality of life: A comment on Chaturvedi et al. (2018)


Saurav Basu 
 Department of Community Medicine, Maulana Azad Medical College, New Delhi, India

Correspondence Address:
Dr. Saurav Basu
Department of Community Medicine, Maulana Azad Medical College, New Delhi,
India




How to cite this article:
Basu S. Antidiabetic medication and quality of life: A comment on Chaturvedi et al. (2018).Perspect Clin Res 2018;9:107-108


How to cite this URL:
Basu S. Antidiabetic medication and quality of life: A comment on Chaturvedi et al. (2018). Perspect Clin Res [serial online] 2018 [cited 2019 Oct 22 ];9:107-108
Available from: http://www.picronline.org/text.asp?2018/9/2/107/231101


Full Text

Dear Editor,

I read the article by Chaturvedi et al. (2018) with considerable interest.[1] Measures for improving the quality of life (QOL) should be treated as an essential part of diabetic care. The findings of the authors show that improving QOL correlates with improvement in metabolic outcomes such as glycemic control. However, I have two concerns regarding the methodology and conclusion advanced by the author which need clarification.

The authors wanted to answer the research question that whether antidiabetic drug treatment improves the QOL and other biochemical parameters in diabetes mellitus (DM) patients. However, the mean duration of diabetes in the patients was over 10 years, so most patients were likely to be on treatment before enrollment in the Chaturvedi (2018) study. In this regard, for the study to have answered the desired research question, it should have preferably included only newly diagnosed DM patients who were previously not on standard antidiabetic treatment consisting of either oral hypoglycemic agents (OHAs) or insulin. This is because QOL and metabolic outcomes in DM patients are not constant but are likely to show variation with time depending on patient factors such as level of stress, extent of medical adherence, change in drug therapy, or onset of any diabetes-related complications.[2] Among the previously diagnosed patients on antidiabetic treatment, therapeutic outcomes such as glycemic control are likely to improve on increasing adherence to medication, self-care practices, reducing stress, and intensification of drug therapy using newer OHAs or insulin.[3] The Chaturvedi (2018) study should report the change in the determinants of the above study outcomes during the 6-month period of observation.

The authors concluded that using fewer medicines offers better treatment satisfaction and QOL in the patient. Nevertheless, the authors finding could be due to confounding since patients with recent onset of DM need fewer medicines to manage their diabetes and are less likely to suffer diabetes-related complications compared to DM patients with long duration of diabetes.[4] Moreover, the failure to sufficiently intensify the antidiabetic treatment in patients with poor glycemic control poses the risk of therapeutic inertia and likelihood of adverse health outcomes.[5]

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Conflicts of interest

There are no conflicts of interest.

References

1Chaturvedi R, Desai C, Patel P, Shah A, Dikshit RK. An evaluation of the impact of antidiabetic medication on treatment satisfaction and quality of life in patients of diabetes mellitus. Perspect Clin Res 2018;9:15-22.
2Trikkalinou A, Papazafiropoulou AK, Melidonis A. Type 2 diabetes and quality of life. World J Diabetes 2017;8:120-9.
3Basu S, Khobragade M, Kumar A, Raut DK. Medical adherence and its predictors in diabetes mellitus patients attending government hospitals in the Indian capital, Delhi, 2013: A cross sectional study. Int J Diabetes Dev Ctries 2015;35 Suppl 2:95.
4Hayashino Y, Izumi K, Okamura S, Nishimura R, Origasa H, Tajima N, et al. Duration of diabetes and types of diabetes therapy in Japanese patients with type 2 diabetes: The Japan diabetes complication and its prevention prospective study 3 (JDCP study 3). J Diabetes Investig 2017;8:243-9.
5Bailey CJ. Under-treatment of type 2 diabetes: Causes and outcomes of clinical inertia. Int J Clin Pract 2016;70:988-95.