Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject : A survey to collect the insights on the perception and usage of fixed drug combination of Glimepiride + Sitagliptin + Metformin in the management of T2DM (GEM III Survey)

Diabetes is one of the largest global health emergencies of this century, ranking among the 10 leading causes of mortality together with cardiovascular disease (CVD), respiratory disease, and cancer. Diabetes is endemic in India, and as per ICMR-INDIAB-17 study, 101 million people had diabetes, and the number with prediabetes was 136 million in India. T2DM is characterized by insulin resistance and hyperglycemia, which is usually, but not always, accompanied by abnormal lipid metabolism. Insulin resistance generally occurs early in the progression of T2DM and CVD. Traditionally, T2DM is managed in a stepwise approach, which includes lifestyle modification, followed by a single-agent OAD, and then combination therapy. However, this approach has a number of limitations: delays in achieving and maintaining glycemic targets; difficulty in implementing this regimen in routine practice; and delays in switching from monotherapy to combination therapy.

High pill burden and complex treatment regimens decreases adherence. FDCs improve patient compliance, glycaemic control and have potential to decrease risk of complications. Progressive decline of A1C resumes within 6 months after an SU is added to metformin, and increasing SU dose further can increase the chances of side-effects (like hypoglycemia). Adding another drug such as an Dpp4i with novel mechanism of action & Beta cell preserving effects to SU + Metformin, can help achieve glycaemic goals, without additional risk of weight gain (potential for weight reduction) in patients with T2DM.

The purpose of this survey is to understand to the perception and usage of fixed drug combination of Glimepiride + Sitagliptin + Metformin in the management of T2DM.

We invite you to participate in this survey. On acceptance, you will need to fill the survey questionnaire form provided.

We would encourage you to carefully fill all available information to the fullest in the questionnaire.

If you agree to participate in the said survey, we would request you to sign and return the enclosed reply along with your visiting card for accuracy of records.