ĐIỀU TRỊ THUỐC HẠ ĐƯỜNG HUYẾT TRÊN NGƯỜI BỆNH ĐÁI THÁO ĐƯỜNG TYPE 2 MỚI CHẨN ĐOÁN

Abstract

Introduction: Type 2 diabetes is a common cardiovascular risk factor in Vietnam. Initiating guideline-recommended hypoglycemic therapy at diagnosis is crucial for achieving glycemic control and improving prognosis. Most hypoglycemic drugs, except insulin, lower HbA1c similarly but differ in their safety profiles and mechanisms of pathophysiological action. Objective: The study was conducted to determine the prescription rates of hypoglycemic agents according to current guidelines for newly diagnosed type 2 diabetes patients. Research Methods: A descriptive cross-sectional study was conducted on type 2 diabetes patients diagnosed within six months at the Endocrinology and Family Medicine clinics of the University Medical Center, Ho Chi Minh City. Prescriptions were recorded at the time of the patient's visit. Compliance with recommendations for hypoglycemic treatment was evaluated based on the 2020 treatment guidelines of the Ministry of Health of Vietnam and the 2022 guidelines of the American Diabetes Association (ADA). Results: 275 newly diagnosed type 2 diabetes patients participated in the study. The prescription rates for hypoglycemic agents, including metformin, sulfonylurea, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 agonists, α-glucosidase inhibitors, meglitinides, and insulin were, respectively, 84%, 22.9%, 58.5%, 16%, 0.4%, 0.4%, 1.5%, and 10.2%. Most patients need two medications to control blood glucose. The study showed that 96% of patients were treated with hypoglycemic agents upon diagnosis, with 20.5% prescribed insulin for patients with HbA1c ≥ 9% or very high fasting blood glucose ≥ 300 mg/dL and 25% selecting SGLT2 inhibitors and/or GLP-1 agonists as recommended. Among patients treated with oral hypoglycemic agents, five were not appropriately prescribed linagliptin doses. Conclusion: Guideline-directed hypoglycemic treatment in newly diagnosed type 2 diabetes patients needs further optimization, particularly in the use of SGLT-2 inhibitors and GLP-1 agonists.