Challenges for Effective Glycemic control in T2DM during Covid-19 pandemic and Use of Glimepiride/Metformin FDC: Opinion from Indian Clinicians

Abstract

Abstract Background: Effective glycemic control is associated with reduced risk of Covid-19 severity, complications and mortality, and choice of antidiabetic therapy is crucial for achieving it. Objective: To understand the perspective of clinicians on Glimepiride/Metformin (Glime/Met) FDC for the management of Indian T2DM patients during Covid-19 pandemic. Method: A structured objective questionnaire was administered to 153 clinicians across India via google forms and the responses were analyzed descriptively. Results: Clinicians reported the lack of physical activity (85%) and stress (78%) as the top reasons for uncontrolled glycemia during Covid-19 pandemic. 75% of clinicians reported that Glime+Met FDC is preferred owing to its good antihyperglycemic efficacy while 25% also reported other factors- weight neutrality, low-risk of hypoglycemia, CV safety, etc. 80% of the clinicians agreed that Glime+Met FDC is preferred as a safe prescription for T2DM across spectrum of hyperglycemia and age. For patients uncontrolled on Glime+Met FDC, 78% of the clinicians would prefer uptitration while, 22% would add another antidiabetic. Clinicians rated challenges in managing diabetes during the Covid-19 pandemic as in-clinic consultation (64%) > adherence to diet, lifestyle and treatment (63%) > laboratory investigations (57.5%) > virtual treatment advise to newly diagnosed patients (57%). Clinicians opined that patient education, stock-keeping of medicines for 2-3 months, patient reminders, and cost-effective therapies like Glime+Met FDC can improve treatment adherence. Conclusion: Treatment adherence, and availability of effective and safe medications are crucial in achieving optimal glycemic control in T2DM. Clinicians consider Glime+Met FDC as a therapy of choice owing to its clinical efficacy, safety, and weight neutrality. Keywords: Type 2 diabetes; modern sulfonylurea; glimepiride; antidiabetic fixed dose combination; glycemic control Abbreviations: T2DM: Type 2 diabetes mellitus; FDC: Fixed Dose combination; CV: Cardiovascular Funding and Conflicts of Interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Dr. Mahesh Abhyankar and Dr. Silki are employees of USV Pvt. Ltd.