Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject: SMART 3.0: Selection of therapies and understanding combination treatment approaches in Type 2 Diabetes

Diabetes is a condition characterized by insufficient or inadequate pancreatic insulin secretion, which can be inherited or acquired. It is an important chronic metabolic condition that needs lifestyle changes along with medications.(1) Lifestyle modifications include physical exercise, nutritional modifications, diabetes self-management education and support, and psychological care.. (2)

It affects about 422 million people worldwide, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year. This number is expected to increase, with estimates for 2030 and 2045 placing them at 578 million (10.2%) and 700 million (10.9%), respectively. (3)

India is home to the world's second highest number of diabetic patients. India now has over 101 million people living with diabetes compared to 70 million people in 2019, as per an ICMR study making it the second-largest T2DM population globally.(3) Within the age group of 20–79 years, India has 74.9 million diabetics in 2021 projected to increase to 124.9 million by 2045. According to International Diabetes Federation (IDF), one out of every seven diabetic adults worldwide reside in India, and one in every third household has diabetic patients. (4) A poor modern diet and insufficient physical activity are considered to be the primary causes of the T2DM pandemic in low- and middle- income nations, which is changing the dynamics significantly. (5)

Diabetes management in India is complicated by several factors which include dietary habits, physical activity levels, how people use healthcare infrastructure, and how it is delivered. T2DM patients who are overweight, controlling energy intake to achieve weight reduction is likely to improve glycemic control to the extent that will obviate or delay the need for oral agents or insulin. If it's already on medication, one should expect increased nutritional therapy to improve overall glycemic control and often lead to a dose reduction.(6)

Purpose of the study is To understand the preferences of healthcare professionals for OADs, either as single agents or fixed-dose combinations (FDCs), in patients who are uncontrolled T2DM.

To explore the therapeutic strategies employed by healthcare professionals for managing patients with uncontrolled T2DM and associated comorbidities

To understand the prescribing patterns and rationale for using the FDC of dapagliflozin and Sitagliptin in clinical practice

We invite you to participate in this study. On acceptance, you will need to go through a paper based or web based survey questionnaire. A Survey questionnaire form will be used to record the responses of the healthcare providers.

Data obtained from the survey data will be analyzed using appropriate statistical tools.

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.