Prescribing Patterns of Antidiabetics and Neuropathic Pain Medications in Type 2 Diabetes Mellitus with Diabetic Peripheral Neuropathy and Diabetic Nephropathy: A Cross-Sectional Study In Tertiary Care Hospital, Lahore
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Background: Diabetic nephropathy and diabetic peripheral neuropathy are common complications of type 2 diabetes mellitus and can substantially influence medication selection, dosing, and safety. Objective: This study aimed to evaluate prescribing patterns of antidiabetic and neuropathic pain medications and identify factors associated with potentially unsafe prescribing among patients with type 2 diabetes mellitus, diabetic nephropathy, and diabetic peripheral neuropathy. Methods: A descriptive cross-sectional study was conducted among 306 patients attending Mayo Hospital Lahore and Lahore General Hospital, Lahore. Data were extracted from prescriptions, clinical records, and laboratory reports. Demographic, clinical, laboratory, and medication-related variables were summarized using descriptive statistics, and multivariable logistic regression was used to identify predictors of potentially unsafe prescribing. Results: The mean age was 55.28 ± 9.56 years, and 184 patients (60.1%) were female. Metformin was prescribed to all patients, while SGLT2 inhibitors were prescribed in 123 patients (40.2%). Pregabalin was prescribed in 285 patients (93.1%), and vitamin B12 supplementation in 197 patients (64.4%). Renal-function-related prescribing concerns included metformin use despite low eGFR in 121 patients (39.5%), inappropriate sitagliptin dosing in 35 (11.4%), and SGLT2 inhibitor use below the recommended renal range in 15 (4.9%). Older age, retinopathy, and higher HbA1c were associated with increased odds of potentially unsafe prescribing. Conclusion: Renal-function-related prescribing concerns were frequent, supporting the need for structured medication review, renal-dose adjustment protocols, and multidisciplinary pharmacotherapy monitoring
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