Rates and Factors Associated With Laxative Prescription Among Type 2 Diabetes Patients in Primary Care

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Kantapong Thamcharoensak
Narucha Komolsuradej
Napakkawat Buathong
Kittisak Choomalee

Abstract

Background: Diabetes mellitus (DM) is a common noncommunicable disease. Several gastrointestinal symptoms such as diarrhea, chronic constipation, and fecal incontinence are often observed in DM patients; among these, chronic constipation is the most commonly reported. Given the growing prevalence of diabetes-associated chronic constipation, the problem of laxative prescribed without diagnosis of constipation among type 2 diabetes patients has been found in the primary care unit. Therefore, it should attend to investigate the rate and factors associated with laxative prescription in type 2 diabetes.


Objective: To evaluate the rate and factors associated with laxative prescription in type 2 diabetic patients at the primary care unit and general practitioner outpatient clinic at Songklanagarind Hospital.


Results: Overall, 386 patients diagnosed with type 2 diabetes were enrolled (55.7% female; mean age, 63.3 years; median duration of type 2 diabetes, 7 years; median visit in 5 years of each patient, 44 visits). Prevalence of laxative prescriptions was 16.6%. Rate of laxative prescriptions was 1.7% within 5 years. Patients with no diagnosis constipation according to ICD-10 about 81.2%. The statistically significant factors associated with laxative prescriptions in diabetic patients were age, number of hospital visit in 5 years, duration of type 2 DM disease, height, diastolic blood pressure, hemoglobin, hematocrit, serum uric acid, and glomerular filtration rate.


Conclusions: Most laxative prescribed diabetic patients were without written diagnosis of constipation. Factors associated with laxative prescriptions were age, number of hospital visit, duration of type 2 DM disease, height, diastolic blood pressure, hemoglobin, hematocrit, serum uric acid, and glomerular filtration rate.


 

Article Details

How to Cite
Thamcharoensak, K., Komolsuradej, N. ., Buathong, N. ., & Choomalee, K. . (2020). Rates and Factors Associated With Laxative Prescription Among Type 2 Diabetes Patients in Primary Care. Ramathibodi Medical Journal, 43(4), 20–27. https://doi.org/10.33165/rmj.2020.43.4.241632
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Original Articles

References

Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003;26(5):1553-1579. doi:10.2337/diacare.26.5.1553.

Forgacs I, Raja O. Diabetes and the gastrointestinal tract. Medicine. 2015;43(6):347-351. doi:10.1016/j.mpmed.2015.03.008.

Phillips LK, Rayner CK, Jones KL, Horowitz M. An update on autonomic neuropathy affecting the gastrointestinal tract. Curr Diab Rep. 2006;6(6):417-423. doi:10.1007/s11892-006-0073-0.

Ueno N, Inui A, Satoh Y. The effect of mosapride citrate on constipation in patients with diabetes. Diabetes Res Clin Pract. 2010;87(1):27-32. doi:10.1016/j.diabres.2009.09.024.

Cheng C, Chan AO, Hui WM, Lam SK. Coping strategies, illness perception, anxiety and depression of patients with idiopathic constipation: a population-based study. Aliment Pharmacol Ther. 2003;18(3):319-326. doi:10.1046/j.1365-2036.2003.01663.x.

Maleki D, Locke GR 3rd, Camilleri M, et al. Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000;160(18):2808-2816. doi:10.1001/archinte.160.18.2808.

Enck P, Rathmann W, Spiekermann M, et al. Prevalence of gastrointestinal symptoms in diabetic patients and non-diabetic subjects. Z Gastroenterol. 1994;32(11):637-641.

Schvarcz E, Palmér M, Ingberg CM, Aman J, Berne C. Increased prevalence of upper gastrointestinal symptoms in long-term type 1 diabetes mellitus. Diabet Med. 1996;13(5):478-481. doi:10.1002/(SICI)1096-9136(199605)13:5<478::AID-DIA104>3.0.CO;2-5.

Janatuinen E, Pikkarainen P, Laakso M, Pyörälä K. Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol. 1993;28(5):427-432.

Maxton DG, Whorwell PJ. Functional bowel symptoms in diabetes--the role of autonomic neuropathy. Postgrad Med J. 1991;67(793):991-993.

Puig-Pijoan A, Giralt-Steinhauer E, Zabalza de Torres A, et al. Underdiagnosis of unilateral spatial neglect in stroke unit. Acta Neurol Scand. 2018;138(5):441-446. doi:10.1111/ane.12998.

Aaron SD, Boulet LP, Reddel HK, Gershon AS. Underdiagnosis and overdiagnosis of asthma. Am J Respir Crit Care Med. 2018;198(8):1012-1020. doi:10.1164/rccm.201804-0682CI.

Yamada E, Namiki Y, Takano Y, et al. Clinical factors associated with the symptoms of constipation in patients with diabetes mellitus: a multicenter study. J Gastroenterol Hepatol. 2018;33(4):863-868. doi:10.1111/jgh.14022.

Talley NJ, Jones M, Nuyts G, Dubois D. Risk factors for chronic constipation based on a general practice sample. Am J Gastroenterol. 2003;98(5):1107-1111. doi:10.1111/j.1572-0241.2003.07465.x.

Lins Neto MÁF, Moreno KAM, Graça RCC, Lima SMG. Constipation prevalence in diabetic patients. J Coloproctol (Rio J). 2014;34(2):83-86 doi:10.1016/j.jcol.2014.04.001.

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