Background Patients with diabetes often receive multiple drug regimens termed ‘polypharmacy’. Since polypharmacy imposes excessive cost, we evaluated the prescriptions of patients with diabetes regarding polypharmacy, and its association with HbA1c levels and cost. Method 102 million prescriptions of Iranian health insurance data in 2015 and 2016 were overlapped with STEPS Iran 2016 survey database. Then, 2075 Metabolic syndrome patients were selected. Among the patients who consumed anti diabetes medications; individual and sociodemographic factors, and polypharmacy were assessed and association between these factors and HbA1c levels were quantified using logistic regression. Each patient’s prescription costs in 2015 and 2016 and its association with individual and sociodemographic factors as well as polypharmacy was assessed using linear regression. Results Out of 2075 metabolic syndrome patients, 205 patients had diabetes according to their fasting blood glucose in 2015 and 2016. HbA1c was significantly more controlled (≤7%) in urban areas. No significant association existed between polypharmacy and HbA1c levels. Medication cost was significantly higher in male patients, patients above 80 years, and patients with >12 years of education (p< 0.05). Area of living and wealth index had no significant association with cost. Conclusion Although diabetic patients with polypharmacy significantly pay more money for their prescriptions, no significant difference was observed between their HbA1c levels.

Purpose The prevalence of metabolic syndrome is 4.8% in adults worldwide. In the treatment process, Polypharmacy which is defined as concomitant use of ≥ 5 medications in a prescription is common and it may lead to untoward Drug-drug interactions. Methods A population-based, cross sectional study was conducted following joining the data from Iranians Health Insurance Service prescriptions in 2015 and 2016 with patients data from STEPwise approach to risk factor Surveillance 2016 survey in Iran. Epidemiology of polypharmacy was evaluated among Metabolic syndrome patients, and association between polypharmacy and individual and sociodemographic factors was assessed with polypharmacy being the dependent variable. Potentially Inappropriate Medication was evaluated among the ≥ 60 year-olds and, as the dependent variable, its association with individual and sociodemographic factors as well as polypharmacy was evaluated. Drug-drug interactions were assessed using LexiComp® software. Logistic regression analysis was used to analyze the associations. Results Out of 2075 patients, 10.3% had polypharmacy. There was significant association between polypharmacy with age and area of living (p < 0.001). Potentially Inappropriate Medication was 13.2% and its association with area of living was significant (p < 0.001). Among patients with polypharmacy, 91.4% in 2015, and 90.1% in 2016 had drug-drug interactions. Prevalence of C, D, and X risk category and prescriptions with 3 kinds of risk categories (C + D + X) was more among patients with polypharmacy.