DiSi Survey: Use of Generic DPP4i-SGLT2i Fixed-dose Combinations in Indian Clinical Practice.

Abstract

India has a high burden of patients with diabetes mellitus (DM). Challenges to managing type 2 diabetes (T2DM) in India are unique. Indian T2DM patients do not just present with DM alone, but with clustering of cardiovascular (CV) risk factors like hypertension (HTN), dyslipidemia, and obesity. Furthermore, Indian patients also have lesser baseline beta-cell function compared to global reference populations. In India, various cost-effective, generic, fixed-dose combinations (FDC) of dipeptidyl peptidase 4 inhibitors (DPP4i) with sodium-glucose cotransporter 2 inhibitors (SGLT2i) are available for the management of T2DM. However, to the best of our knowledge, scant surveys have studied the clinical practice nuances regarding the use of these FDCs in Indian settings. Hence, we designed and conducted a knowledge, attitude, and practice (KAP) survey to study the attitude and practice of Indian physicians with regard to patient population and placement of generic DPP4i-SGLT2i FDCs. Our survey showed that in India, patients often present with a high baseline HbA1c. From a glycaemic control perspective, DPP4i-SGLT2i FDCs are preferred in treatment-naïve patients with HbA1c >8% and those with HbA1c >8.5% despite metformin monotherapy. Also, 85% physicians observed a reduction in SGLT2i associated GUTIs with use of DPP4i-SGLT2i FDCs or concomitant use of these agents. Part of these survey findings were presented at the American Diabetes Association (ADA) 2024 Congress held in Orlando, Florida.