Drug prescription in diabetic patients in Stockholm in 1992 and 1995 - Change over time

Objective: To describe and compare the distribution of prescribed drugs in diabetic patients between 1992 and 1995. Methods: Two cross-sectional surveys of a random selection of medical records of diabetic patients, from three community health centres (CHCs) in the Stockholm metropolitan area, were carried out. The age of the subjects ranged from 20 to 84 years. The number of prescriptions of pharmaceutical preparations given to the diabetic patients was noted, as well as classification of the diabetes, the metabolic outcome, and concomitant hypertension. Results: Between 1992 and 1995, the use of oral antidiabetics increased significantly from 43 to 57% of the patients and the rate of treatment with diet only decreased from 30 to 20%. Combination treatment with oral drugs and insulin rose significantly from 1 to 8% of the patients. However, the greatest increase observed between 1992 and 1995 concerns cardiovascular drugs. The prescription rate of ACE inhibitors increased from 5 to 21%, of loop diuretics from 19 to 28%, of ASA from 9 to 21%, and of lipid-lowering agents from 1 to 7%. There was also a considerable variation between the three CHCs. Despite the more aggressive diabetic treatment strategies, the metabolic state was unchanged and unsatisfactory for 40-50% of the patients. Conclusions: There have been major changes towards more active pharmacological treatment regarding antidiabetic, cardiovascular, and lipid-lowering agents.