Assessment of Therapeutic Outcome and Medication Adherence in Diabetics Consumed Insulin, Oral Hypoglycemics and Poly Herbal Drugs

Introduction: The overwhelming of consumption of antidiabetes poly herbal products (PHP) would influence the outcomes of hyperglycemia management. The underlying reasons were yet to be reveled; thought to be the herb-drug interactions and delayed adherence towards the conventional anti-diabetes drugs. We hypothesized that consumption of poly herbal antidiabetes products would influence the therapeutic outcome while on treatment with Insulin, oral hypoglycemic (OHG) drugs and/or both. We also hypothesized that trends towards poly herbal antidiabetes products would change the adherence towards conventional drug treatments and life style modifications. Methods: A total of 1251 patients with both type 1 and 2 diabetes mellitus of age 20-60 year, their fasting blood sugar (FBS) >110 mg/dl and /or random blood sugar (RBS) >150 mg/dl and urine sugar level >50 mg/dl were enrolled. The patients used herbal products, steroids, pregnant and lactating women and diabetic micro vascular disorders were excluded. The physical and vital parameters, symptoms of hyper/hypoglycemia were monitored. Diabetes Self-Assessment Questionnaire 16 (DSMQ-16); the scale used to assess their glucose management, physical activity, dietary control and physician contact was administered to each patient as a measure of adherence to the treatment. Results: The adherence level towards Insulin was found to be decreased while oral hypoglycemic drugs showed well. The consumption of PHP was most prevalent as well as adherence level. The markers of hyperglycemia were found to be altered in patient consumed PHP along with OHG drugs (p<0.05). The random blood sugar (RBS) levels were not found to be normalized (p<0.05) while fasting blood sugar (FBS) were found to be responded (p<0.05). Conclusion: The PHP had a significant influence on OGH drugs. Since the adherence towards Insulin was decreased and assumed OHG-herb interactions the hyperglycemia management was not carried out. We recommend noncompartment Pharmacokinetic as well as Pharmacodynamics studies along with therapeutic drug monitoring.