Real-world Data of Glycemic Control in a Suburban Population in Northern India during the COVID-19 Pandemic

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Abstract Background: This study compared the 2-year glycemic outcomes with oral antidiabetic drugs (OADs) versus combination of OADs with insulin among the real-world patients at a single suburban center in India during the COVID-19 pandemic. Methods: Patients aged >18 years on the treatment for type 2 diabetes mellitus were included and followed up for 2 years. The patients were divided into four groups according to their antidiabetic medication as follows: (1) sodium-glucose cotransporter-2 inhibitors (SGLT2i) + insulin + OADs; (2) SGLT2i + OADs; (3) insulin + OADs (excluding SGLT2i); and (4) OADs excluding SGLT2i. Patients who were reluctant to initiate insulin as add-on therapy or those already taking insulin but wanting to switch to OADs were prescribed SGLT2i as add-on therapy. The parameters measured at every follow-up were blood pressure, weight, fasting blood sugar (FBS), postprandial blood sugar, and HbA1c. Results: In all, 1204 patients were included in the study. The mean age of patients was 59.07 ± 13.08 years, and 729 (60.54%) were males. Out of 1204 patients, the HbA1c data were available for only 472 patients. All glycemic parameters were maintained in the SGLT2i + Insulin + OADs group over the period of 3 years with no significant change in their values. The number of patients in the SGLT2i + OADs group more than doubled over the 2 years of follow-up. There was a significant improvement in weight and FBS at year 2 in this group. A significant improvement in HbA1c and FBS was seen in patients with baseline HbA1c ≥10 at baseline. No statistically significant change was observed in any of the clinical parameters in patients in the Insulin + OADs (excluding SGLT2i) group. Only about 50% of those who were on insulin at baseline, continued insulin at the first and second follow-up. In the OADs (excluding SGLT2i) group, weight and post lunch blood sugar showed a significant decrease at the second follow-up. Among patients who remained on OADs throughout the study, there was a significant improvement in HbA1c from baseline at year 2, although other parameters did not show any significant improvement. Conclusion: Patients on various OAD regimens showed better glycemic control compared to those on combined insulin and OADs in this study in a suburban population in India.