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

Objective: The present survey-based study aims to gather the clinicians’ perspective regarding the prescription patterns of sodium-glucose co-transporter-2 (SGLT2) inhibitors with a special focus on dapagliflozin for effective management of type 2 diabetes mellitus (T2DM) in Indian settings.
Methodology: The cross-sectional questionnaire-based survey consisted of 19 carefully crafted items designed to capture clinicians' perspectives on factors such as patient age distribution, awareness levels about diabetes, utilization of oral anti-diabetic drugs (OADs), recent advancements in OADs, co-morbidities, cardiovascular (CV) complications, SGLT2 inhibitors usage, prescribing patterns, and preferences for combination therapies.
Results: Majority (75%) of the clinicians recommended prescribing SGLT2 inhibitors to achieve both glycemic targets and leverage pleiotropic benefits. Nearly 59% noted a reduction in HbA1c levels by 1 to 1.5% after three months of treatment, while 54% reported reduced rates of CV death and hospitalization as the primary pleiotropic benefit. Most clinicians (58.1%) prescribed SGLT2 inhibitor + DPP4 inhibitor combination for patients with uncontrolled T2DM, and CV and renal comorbidities. Additionally, 49% of clinicians noted that 21-30% of their patients required SGLT2 inhibitor + DPP4 inhibitor therapy, with 52.51% initiating it when the entry level was HbA1c>8%. Majority (98%) of the clinicians favored dapagliflozin as the commonly prescribed SGLT2 inhibitor in their practice, with preferences split between metformin (41%) and DPP4 inhibitors (39%). Additionally, a significant proportion (74.3%) observed a reduction in systolic blood pressure of 5 to 10 mmHg with dapagliflozin. Additionally, a significant proportion (74.3%) observed a reduction in systolic blood pressure of 5 to 10 mmHg with dapagliflozin. 
Conclusion: The survey underscored clinicians' preference for SGLT2 inhibitors to achieve glycemic control and leverage pleiotropic benefits. Combination therapy with SGLT2 inhibitor + DPP4 inhibitor is widely prescribed for uncontrolled T2DM and comorbidities, emphasizing its efficacy. Clinicians favored dapagliflozin as it demonstrates significant reductions in systolic blood pressure, reinforcing its therapeutic value in managing T2DM and associated complications.