What does this research mean for the field?

In patients with Type 2 Diabetes Mellitus, polypharmacy significantly increases with age and comorbidity burden, and while general prescribing aligns with guidelines, newer cardioprotective and renoprotective agents like SGLT2 inhibitors and GLP-1 receptor agonists remain underutilized. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To explore the link between comorbidity patterns and the use of specific medications in patients with type 2 diabetes mellitus.

June 20, 2026Open Access

Association of Comorbidity Patterns with the Utilization of Comorbidity-specific Medications in Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study

Key Points

To explore the link between comorbidity patterns and the use of specific medications in patients with type 2 diabetes mellitus.
Cross-sectional study conducted from July 2022 to September 2023 with 150 adults with T2DM.
Data extracted from hospital records and prescriptions reviewed for medication appropriateness.
Statistical analyses included Chi-square, ANOVA, and logistic regression.
Dyslipidemia (79.3%) and hypertension (48.7%) were the most common comorbidities.
Logistic regression showed ≥2 comorbidities (OR 4.3, P < 0.001) and age ≥60 (OR 2.1, P = 0.01) as predictors of polypharmacy.
Low uptake of cardioprotective drugs associated with cardiovascular/renal disease (OR 3.5, P = 0.03).

Abstract

Abstract Introduction: Type 2 diabetes mellitus (T2DM) is frequently complicated by comorbidities such as hypertension, dyslipidemia, cardiovascular disease, and chronic kidney disease, often necessitating polypharmacy. Understanding prescribing patterns and their appropriateness is critical to optimize patient outcomes. Aims: To evaluate the association between comorbidity patterns and the utilization of comorbidity-specific medications in T2DM, with emphasis on polypharmacy, rational prescribing, and guideline adherence. Material and Methods: A cross-sectional study was conducted in the General Medicine outpatient department of Calcutta National Medical College (July 2022–September 2023). Data from 150 adults with T2DM were extracted from paper-based hospital records using a structured case report form. Prescriptions were systematically reviewed for comorbidity-specific drug use, duplication, and drug-drug interactions. Statistical analyses included Chi-square, ANOVA, and logistic regression. Results: Dyslipidemia (79.3%) and hypertension (48.7%) were the most prevalent comorbidities. Atorvastatin was prescribed in 82.7% of dyslipidemic patients, while amlodipine (39.3%) was the most common antihypertensive. Polypharmacy increased significantly with comorbidity burden ( P < 0.001), with patients having ≥3 comorbidities receiving a mean of 8.2 drugs. Logistic regression identified ≥2 comorbidities (Odds ratio OR 4.3, P < 0.001) and age ≥60 years (OR 2.1, P = 0.01) as predictors of polypharmacy. Uptake of Sodium-glucose cotransporter-2 inhibitors/glucagon-like peptide-1 receptor agonists was low (<20%) but was associated with cardiovascular/renal disease (OR 3.5, P = 0.03) and higher socioeconomic status. Duplication (4.7%) and potential drug-drug interactions (7.3%) were identified. Conclusions: Prescribing practices generally reflected guideline recommendations, but underutilization of cardioprotective and renoprotective agents, alongside inappropriate polypharmacy, remain challenges. Strategies to improve affordability, enhance physician awareness, and incorporate deprescribing are essential for rational diabetes care in India.

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