Polypharmacy and associated factors in patients with type 2 diabetes: a nationwide cross-sectional study (TEMD-2 polypharmacy study).

BACKGROUND

Polypharmacy is a growing concern in the management of patients with Type 2 diabetes mellitus (T2DM), as multiple comorbidities necessitate complex pharmacological regimens. However, excessive medication use has been associated with adverse drug reactions, medication non-adherence, and poor clinical outcomes. Understanding the impact of polypharmacy in patients with T2DM is essential for optimizing treatment strategies.

METHODS

This nationwide, cross-sectional study analyzed data from a 2023 survey involving 4,956 patients with T2DM across Türkiye. Polypharmacy was defined as the use of five or more medications. Demographic characteristics, comorbidities, diabetes-related complications, and laboratory parameters were compared between patients using 1-4 medications and those with polypharmacy. Logistic regression analysis identified independent predictors of polypharmacy.

RESULTS

Polypharmacy was observed in 46.7% (n = 2,312) of the patients. Those with polypharmacy were significantly older, had a longer diabetes duration, higher body mass index, and elevated systolic blood pressure (p < 0.001). The prevalence of macrovascular and microvascular complications was higher in this group (p < 0.001), and severe hypoglycemia was more frequent (p = 0.034). Regression analysis identified older age, longer diabetes duration, dyslipidemia, hypertension, nonalcoholic fatty liver disease, hypothyroidism, osteoporosis, coronary artery disease, cerebrovascular disease, neuropathy, and nephropathy as factors independently associated with polypharmacy (p < 0.001).

CONCLUSION

Polypharmacy is highly prevalent in older adults with T2DM and is associated with an increased burden of complications. These findings highlight the importance of careful medication assessment in patients with T2DM with complex comorbidity profiles.

CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov identifier is NCT06347445.