Alkem

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LINEAR Study

A retrospective analysis of usage of FDC of Linagliptin and Dapagliflozin in Indian T2DM patients in real world practice (LINEAR study)

BASIC DETAILS

Patient code (Do not write name here) *

Date *

Diagnosis (Type 2 diabetes Mellitus)

Demographics

Patient's Age *

Gender*

Male Female

Height (cm) *

Weight (kg) *

Risk factors

Obesity (BMI) *

Underweight (<18.5 kg/m²) Normal BMI (18.5-22.9 kg/m²) Overweight (23.0 -24.9 kg/m²) Obese (≥25 kg/m²)

Active Smoker *

Yes No

Alcohol intake *

Yes No

Tobacco use *

Yes No

Family history of diabetes *

Yes No

Physical inactivity *

Yes No

Complication at the time of diagnosis (tick as applicable) *

Neuropathy Nephropathy Stroke CAD Retinopathy Any Other

Clinical examination *

Systolic BP (mm Hg)

Diastolic BP (mm Hg)

Drug now prescribed *

Dapagliflozin (10mg) + Linagliptin (5mg) Dapagliflozin (5 mg) + Linagliptin (5mg)

Key reason to choose this FDC (tick as applicable) *

High baseline HbA1c Cardiovascular benefit Excellent efficacy Good safety profile Weight loss Insulin resistance improvement Renal safety Tolerated well by elderly patients with cardiac and renal comorbidities

Other medications prescribed *

Drug	Dose	Frequency

Investigations *

	Baseline	Post 3 months treatment
HbA1c
FPG (mg/dl)
PPG (mg/dl)
Body weight (kg)
BP (mm hg)
eGFR (mL/min/1.73 m2)

Other parameters

Clinician's Global Assessment of safety (Tick Appropriate) *

Excellent Good Fair Poor

Clinician's Global Assessment of Effectiveness (Tick Appropriate) *

Excellent Good Fair Poor

Safety profile

Have you observed any other adverse drug reactions with usage of FDC *

Yes No

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