Chronic Diseases: Diabetes Patients (Polypharmacy)

Use of multiple medications in the same patients (Polypharmacy) nowadays is a common practice all over the world to treat chronic disorders like diabetes mellitus (DM) and hypertension. These practices are acceptable to treat single and multiple disorders, which occur simultaneously. Polypharmacy sometimes unavoidable. Recently, the standard of healthcare in most chronic conditions achieved by given that multiple drug therapy. The comorbidities of diabetes usually contain hypertension, dyslipidemia, heart failure, and coagulopathies, each of these diseases may need one or more drugs to suitable control. Polypharmacy is predictable in treating a common chronic disease such as diabetes. The possible for polypharmacy will continue to increase
Knowledge in this field makes physicians and pharmacists capable to prevent or even reduce these risks from occurrence through doses adjustment or by using alternative drugs. (Agrawal et al., 2013) 1.1. Diabetes mellitus: Diabetes Mellitus is a most common disease in the world, especially in third world countries such as Yemen. Diabetes mellitus is a chronic metabolic disorder characterized by an increase in blood glucose (hyperglycemia) (fasting blood sugar (FBS > 126 mg/dl, or blood glucose >200 mg/dl 2 h after a meal). Diabetes mellitus characterized by hyperglycemia because of a defect in the secretion of the insulin from the pancreas, frequently coexists with insulin resistance. Hyperglycemia happens due to uncontrolled glucose output in hepatic and decrease uptake of glucose by skeletal muscle with reduced glycogen synthesis. Inside renal, when reabsorption of glucose is exceeded, glucose spills through into the urine, which results in glycosuria and triggered an osmotic diuresis (polyuria) which, in turn, lead to dehydration, thirst and increased drinking
(Rang et al., 2015) The most common types of diabetes are type I (insulin-dependent diabetes mellitus, IDDM) and type II (non-insulin-dependent diabetes mellitus, NIDDM); either insulin resistance or a defect in insulin secretion or both causes Type II diabetes. (Imamura et al., 2013). In the type II of diabetes mellitus chronic hyperglycemia can lead to serious complications in the organs, especially in eye, nerves, heart and blood vessels. Therefore, the prevalence of hypertension in type-2 diabetes, may be as high as 50%. (Cantrill and Wood, 2003). Furthermore, the incidence of diabetes mellitus over the world is increasing every year. (IDF, 2014), the high incidence rate of DM in the world may because the consequence of changing patterns of diet and physical activity, increases in obesity, and ageing