Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: Insights on the Diabetes therapy & Awareness (IDEA)

Understanding the usage of SGLT-2i+DPP-4i in the management of T2DM with cardiac co-morbidities

India ranks 2nd globally in number of people with diabetes with the estimate of prevalence doubling by 20451. Despite advancement in the diagnosis, treatment and monitoring over the last decade and a half, nearly 78% patients fail to achieve their glycemic targets2. As there are multiple pathophysiological dysfunctions in T2DM, there is a need for combination therapy to target all pathophysiological pathways to achieve euglycemia. One major difference in Indian T2DM patients is that there is a very high prevalence of co-morbidities3 that co-exist & therefore an important need is to set goals of T2DM treatment beyond glycemic targets.

The latest ADA-EASD Consensus 2022 document for the 1st time states that Metformin should no longer be the 1st line of treatment in T2DM and that newer OADs like the SGLT-2i, GLP-1 RAs, etc should be used if the patients have a high risk of ASCVD, CKD, HF, etc4

SGLT-2i & DPP-4i have become increasingly popular as the preferred choices of treatment for T2DM patients in the recent past. Both these classes have complementary mechanisms of action that address several underlying pathophysiological dysfunctions in T2DM without overlapping drug toxicities.

Now with the FDC of SGLT-2i+DPP-4i being introduced, this new OAD combination offers extra-glycemic benefits like cardio-renal protection, metabolic advantage of weight reduction along with additional safety since they come with a low risk of hypoglycemia.

At Sun Pharma, it is our endeavour to be abreast about the current clinical practices, and perceptions about the existing treatment options. With this survey, we intend to understand this evolving treatment landscape about the use of newer OAD combinations in clinical practice. The summary/outcome of the same will be used to build our in-clinic communication, design future knowledge updation program content, so that we can play an active role in reducing the burden of T2DM in India. All responses will be used at an aggregate level.