Vol. 6, Issue 1, Part A (2024)

Objective: The current survey-based study aims to gather expert opinion regarding the prescription practice of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and its combination with a special focus on dapagliflozin treatment for managing uncontrolled type 2 diabetes mellitus (T2DM) in Indian settings. 
Methodology: The cross-sectional survey utilized a 24-item, multiple-response questionnaire to gather expert opinions from specialists with expertise in managing diabetes. The survey encompassed questions about current prescription practices, clinical observations, preferences, and experiences related to the use of SGLT2i and combination in routine settings for diabetes management.
Result: According to 57% of clinicians, 26-40% of patients needed SGLT2 inhibitors as a monthly add-on to meet their glycemic target. Majority (92.37%) of the clinicians reported dapagliflozin as the commonly prescribed SGLT2i. Nearly 61% of the clinicians reported a reduction in HbA1c by 1 to 1.5% with SGLT2i treatment after three months. More than half (68.32%) of the clinicians reported prescribing a combination of SGLT2i + dipeptidyl peptidase 4 inhibitor (DPP4i) to patients with uncontrolled T2DM, and patients with cardiovascular (CV) and renal comorbidities. According to 52% of the clinicians, 21 to 30% of the patients required a combination of SGLT2i + DPP4i. Half (50%) of the clinicians reported that they preferred SGLT2i + DPP4 inhibitor in T2DM patients with CV comorbidities. About 46% of the clinicians opined empagliflozin + linagliptin as the preferred SGLT2i + DPP4i combination in T2DM patients with renal comorbidities.
Conclusion: The survey highlighted the widespread use of SGLT2 inhibitors, particularly dapagliflozin, and their efficacy in reducing HbA1c levels. Combination therapy with SGLT2 inhibitors and DPP4i is favored for uncontrolled T2DM, CV, and renal comorbidities.