Page 195 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology Medication therapy based on HbA1c

Data were collected using standardized questionnaires of Cardiology (decision no. ПЗ-202007041). All patients
administered to the patients during their hospital visits. provided informed consent to participate in the study and
The questionnaires included sections on demographic received a full explanation of the study’s objectives and
information, medical history, clinical parameters, and methods. Confidentiality of data and the right to withdraw
medication usage. It also included prescriptions issued from the study were guaranteed to all participants. The
within the hospital setting. Clinical, functional, and study was conducted in accordance with the principles of
instrumental parameters, including LVEF and other the Declaration of Helsinki (as revised in 2013) and ethical
metabolic indicators, were assessed. guidelines for clinical research.
2.2. Outcome measurement 3. Results

We employed descriptive data analysis to examine The study included 130 patients diagnosed with
changes in clinical characteristics over time. Changes were T2DM and IHD. Table 1 presents the demographic
calculated by subtracting baseline (first observation) values and clinical characteristics of the cohort. A total of
from follow-up (second observation) values. 75 patients achieved HbA1c levels ≤8% while 55 patients
The primary outcome measure was the achievement did not (≥8%).
of target HbA1c levels (≤8%) in patients with T2DM 3.1. Glycemic control and medication therapy
and IHD. This target level was selected according to
the severity of IHD in patients and in compliance with The study found significant differences in glycemic control
Uzbekistan’s and global treatment standards. Given that and medication therapy between patients who achieved
the patient population consisted primarily of older adults target HbA1c levels (≤8%) and those who did not (≥8%).
with complex/intermediate health, many of whom have The average age of participants with HbA1c levels ≤8%
pacemakers or are at risk of hypoglycemia, a target HbA1c was significantly higher than those with HbA1c levels ≥8%
below 8% was considered clinically appropriate. Moreover, (67.19 ± 9.73 years versus 63.48 ± 9.23 years, t = 4.879,
as the study was conducted in a cardiological hospital, all p=0.027). In addition, a higher frequency of women was
admitted patients had IHD as their primary diagnosis, with present in the HbA1c level ≥8% group compared to the
T2DM as a comorbidity. Therefore, the target HbA1c levels HbA1c level ≤8% group during the second observation
used were not the same as those of a healthy population. (62.5% vs. 48.6%, t = 8.186, p=0.004).

Secondary outcome measures included comparisons The duration of T2DM was higher among patients
of demographic characteristics, clinical parameters, and in the HbA1c level ≥8% group (11.12 ± 4.55 years)
medication usage between patients who achieved target compared to the patients in the HbA1c level ≤8% group
HbA1c levels and those who did not. We also compared (7.04 ± 4.93 years, t = 26.010, p=0.000). Similarly, the
different medication types and outcomes using statistical duration of IHD was longer in the HbA1c level ≥8% group
analysis. We randomly permuted and split our dataset (8.38 ± 3.70 years) compared to the HbA1c level ≤8%
into training (70%) and test (30%) sets to construct linear group (6.93 ± 3.43 years, t = 5.007, p=0.025).
regression and logistic regression models. Table 2 shows the dosages of medications prescribed
2.3. Statistical analysis to patients. The duration of treatment before the second
observation was 9.94±5.71 months (interquartile
Data were analyzed using the Statistical Package for the range = 6.00 – 12.00; minimum = 2.0, maximum = 31.0).
Social Sciences version 23.0. Continuous variables were
presented as mean ± standard deviation (SD). We applied Medication therapy varied significantly between the
t-tests and the Kruskal–Wallis test to compare variables. two groups. Metformin was prescribed to 69.6% of patients
Categorical variables were presented as percentages and with an HbA1c level ≥8%, compared to 35.1% of patients
compared using Chi-squared tests. For non-parametric with an HbA1c level ≤8% (t = 56.324, p=0.000). Insulin
analysis of variance, we used Python 3.7 SciPy library therapy was also more common in the HbA1c level ≥8%
(v1.15). Statistical significance was accepted at p<0.05. In group (41.1% vs. 9.5%, t = 41.289, p=0.000). Table 3 presents
addition, the multinomial logistic regression model from the distribution of antidiabetic medication prescriptions
the Statsmodels library (v.0.15) was used. across patient groups, expressed as percentages.
Empagliflozin, a medication known for its
2.4. Ethical considerations cardiovascular benefits, was prescribed for all 130 patients
The study was approved by the ethics committee of the in the study. Dipeptidyl peptidase-4 (DPP-4) inhibitors
Republican Specialized Scientific-Practical Medical Center were more frequently prescribed to patients with an HbA1c

Volume 9 Issue 3 (2025) 187 doi: 10.36922/EJMO025160133