Abstract | Ciljevi istraživanja: Cilj ovog presječenog istraživanja je utvrditi učestalost nuspojava kod
različitih pripravaka metformina te analizirati učestalost nuspojava s obzirom na način
uzimanja terapije, propisivača terapije i educiranost bolesnika.
Ispitanici i metode: U istraživanju je sudjelovalo 126 ispitanika oboljelih od šećerne bolesti
tipa 2, koji su ispitani pomoću posebno strukturiranog anketnog upitnika. Anektiranje je
provedeno u izravnom fizičkom kontaktu u ambulanti Regionalnog centra za
endokrinologiju, dijabetologiju i poremećaje metabolizma KBC-a Split.
Rezultati: Ovim je istraživanjem utvrđeno da 15,4% bolesnika mijenja terapiju zbog
nuspojava na određeni pripravak metformina. Usporedbom prve i trenutne terapije zapažen je
pad u pojavnosti nuspojava sa statističkom značajnošću (p=0,004). Analizirajući različite
pripravke metformina, neovisno o dozi, Glucophage se pokazao, sa statističkom značajnošću
(p=0,010), onim koji najčešće dovodi do nuspojava. Statističku su značajnost (p=0,007) veće
pojavnosti nuspojava su pokazali i „čisti“ pripravci metformina u odnosu na fiksne
kombinacije. Ispravno uzimanje lijeka (nakon obroka) zabilježeno je kod 63,2% ispitanika,
nešto malo manje pravilno (za vrijeme obroka) lijek uzima 9,6% ispitanika, a neispravno lijek
uzima 27,2% ispitanika. Broj bolesnika koji je ispravno uzimao lijek i u kojeg su zabilježene
nuspojave bio je 8 (10,13%), dok je broj oni koji su neispravno uzimali lijek i u kojih su
zabilježene nuspojave bio 7 (15,22%). Trenutnu metforminsku terapiju je za 112 pacijenata
(89,6 %) propisao specijalist endokrinologije i dijabetologije, dok je za njih 13 (10,4 %) lijek
propisan od strane liječnika obiteljske medicine. U skupini pitanja o samoprocjeni
educiranosti, zabilježili smo da je pojavnost nuspojava prve i trenutne terapije u skupini lošije
informiranih iznosila 25%, dok je u skupini bolje informiranih bila 25,40 % tijekom prve i
11,47 % tijekom trenutne terapije.
Zaključak: Različiti pripravci metformina, neovisno o dozi, razlikuju se u pojavnosti
nuspojava. „Čisti“ pripravci metformina pokazuju veću učestalost nuspojava u odnosu na
fiksne kombinacije. Statistički značajna učestalost nuspojava nije dokazana kod pacijenata
lošije educiranih o šećernoj bolesti. Ne postoji statistička značajnost u pojavnosti nuspojava
ovisno o propisivaču terapije. Nije dokazana statistička značajnost pojavnosti nuspojava kod
neadekvatnog uzimanja terapije. |
Abstract (english) | OBJECTIVE: The objective of this cross-sectional research is to determine the incidence of
side effects of different metformin preparations and to analyse the frequency of side effects
according to the time of therapy intake, with drug prescribers and patient education
SUBJECTS AND METHODS: 126 patients suffering from diabetes type 2 participated in
this research. They were polled using the specially structured survey questionnaire. They
were interviewed in direct physical contact in the Regional Centre for Endocrinology,
Diabetology and Metabolic Disorders of University Hospital of Split.
RESULTS: In this research 15.4% of patients changed their therapy because of side effects
of a certain metformin preparation. When comparing the first and the current therapy, a
statistically significant decrease in frequency of side effects during the current therapy was
found (0.004). In the analysis of different metformin preparations, regardless of the dose,
Glucophage has shown, statistically significantly (0.010), the highest rate of side effects.
Statistical significance (0.007) in the incidence of side effects was also shown in “pure”
preparations in comparison to the fixed combinations. The proper intake of the medicine
(after a meal) reported 63.2% of the patients, the less proper intake (during a meal) was
observed with 9.6% of patients and the incorrect intake was noted in 27.2% of patients. The
number of patients who were taking the medicine in the proper way and were experiencing
side effects was 8 (10.13%) and the number of patients who were taking the medicine the
incorrect way and were also experiencing side effects was 7 (15.22%). The current metformin
therapy, for 112 patients (89.6%), is prescribed by an endocrinology and diabetology
specialist, whilst for the other 13 patients it is prescribed by a family medicine doctor. In the
questions concerning the self-assessment of patients’ education it was noted that the
frequency of side effects of the first and the current therapy in the group of less educated
patients was 25%, while in the group of more educated patients was 25.4% and 11.47%
during the first and the current therapy, respectively.
CONCLUSION: Different preparations of metformin, regardless of the dose, differ in the
frequency of side effects. “Pure” preparations of metformin show a higher frequency of side effects in comparison to fixed combinations. Ther was no statistically significant difference
int he incidence of side effects in patients who were less educated of diabetes. A statistically
significant difference in the frequency of side effects considering the prescriber was not
found. A statistically significant difference in the frequency of side effects considering the
way of drug intake was also not shown. |