Expert Opinion on the Prescription Practice of Oral Hypoglycemic Agents for the Management of Type 2 Diabetes Mellitus in India

Abstract

Background: In India, the prevalence of diabetes is constantly rising in both urban and rural settings. The innovation of newer drugs and the combination of available drugs to treat diabetes has also been increasing. So, this study aimed to understand the practice of clinicians and their perspective towards prescribing appropriate oral hypoglycemic agents for individuals diagnosed with type 2 diabetes mellitus (T2DM) in India. Methods: This cross-sectional survey was conducted among diabetologists who provided consent to participate in the survey on their prescription pattern of oral hypoglycemic agents for management of T2DM individuals. Results: Majority of physicians preferred sitagliptin and dapagliflozin fixed dose combination (FDC) (84.42%) for T2DM individuals with high-risk. The experts also mentioned the FDC reduces time in range (40.04%) when sodium glucose cotransporter-2 inhibitors (SGLT2i) and Dipeptidyl peptidase-4 inhibitors (DPP4i) FDC was given. Sitagliptin and dapagliflozin combination therapy was given majorly to newly diagnosed T2DM individuals with cardiovascular risk (CV risk) (67.07%). Sitagliptin and dapagliflozin FDC for 16 weeks reduces 1.5 to 2% of glycated hemoglobin (HbA1c) (40.63%). Conclusion: Sitagliptin and dapagliflozin FDC was effective for T2DM individuals with high-risk and for newly diagnosed T2DM (and with CV risk). The combination also showed benefit in reducing blood pressure and weight loss when compared to SGLT2 inhibitors monotherapy. Hospitalization rate and CV risk was reduced in individuals who take sitagliptin and dapagliflozin FDC.