Vol. 7, Issue 1, Part A (2025)

Objective: To gather clinicians' insights on managing type 2 diabetes mellitus (T2DM), specifically regarding the use of the dapagliflozin + sitagliptin as dual therapy and sitagliptin + dapagliflozin + metformin fixed-dose combination (FDC) as triple therapy in Indian settings.

Methodology: This cross-sectional study was conducted among clinicians practicing in routine settings across India and employed 23 questions exploring clinicians' feedback, clinical observations, and experiences in managing T2DM, particularly with sitagliptin + dapagliflozin + metformin FDC as a triple therapy. Data were analyzed using descriptive statistics, with findings presented as percentages and illustrated through pie and bar charts.

Result: Out of 365 participants, nearly 88% of clinicians preferred dapagliflozin + sitagliptin as the most common oral antidiabetic (OAD) combination in routine practice. Additionally, 75% favored the dipeptidyl peptidase-4 inhibitors (DPP4i) + sodium-glucose cotransporter-2 inhibitors (SGLT2i) + metformin combination for patients with glycated hemoglobin (HbA1c) levels between 8% and 11%. When selecting dual therapy, the majority of the experts (84.93%) considered factors such as efficacy, hypoglycemia risk, weight gain, cardiovascular (CV), and renal safety. For patients not responding to monotherapy or dual therapy, around 66% of clinicians recommended FDC. The majority of the clinicians (80.82%) considered duration, comorbidities, and patient factors when choosing triple FDC therapy. Approximately 62% of respondents reported urinary tract infections (UTIs) as common side effects, while 90.14% cited benefits such as glycemic control, weight management, and renal safety. Nearly 87% of participants highlighted cardiovascular benefits in high-risk patients with sitagliptin + dapagliflozin + metformin.

Conclusion: The study provides insights into T2DM management, highlighting clinician preferences for drug combinations like dapagliflozin and sitagliptin. Key factors influencing treatment decisions include efficacy, hypoglycemia risk, adherence, and cost. Clinicians noted the benefits of the sitagliptin + dapagliflozin + metformin combination in managing glycemia, body weight, and CV risk.