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Assessing Sitagliptin's Perception and Prescription patterns of Physicians In REcently diagnosed T2DM patients

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Address *

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State *

Pincode *

Contact Number *

Email Id *

Number of years in Practice*

Qualification*

Diabetologist

Endocrinologist

Consulting Physician

Practising Diabetologist

Cardiologist

Nephrologist

ASPPIRE Survey

In your daily practice, how many patients do you see on an average with uncontrolled T2DM? *

≤10%

20-30%

50%

>50%

In your daily practice, how many newly diagnosed patients of T2DM are seen? *

≤10%

10-20%

30%

>50%

How do you define the gender ratio of patients in your practice (M:F)? *

50 to 50

70 to 50

50 to 70

Can’t say

Which is the most frequent age group of your patients? *

30 to 40 years

40 to 50 years

50 to 60 years

< 60 years

According to you, while managing a newly diagnosed T2DM patient, which treatment approach is ideal in the current scenario? *

Guideline Approach (Sequential addition of anti-diabetes agents with “more established use”)

Pathophysiological approach (Using initial combination therapy with agents known to correct defects in T2DM)

Individualized approach - ABCD(E) approach (A=age, B=Body weight, C= Complications, D=Duration of diabetes, E=Life expectancy and expense)

While initiating the treatment in newly diagnosed T2DM patient, which you feel is correct? *

Effective treatment will require multiple drugs in combination

Treatment should be based upon established pathogenic defects and not only on HbA1c levels.

Aggressive treatment approach should be adopted early to prevent disease progression.

According to you, in newly diagnosed diabetic patients without cardiovascular disease, the optimal HbA1c should be: *

≤ 6.0%

6.5% to 7.0%

7.0% to 7.5%

≥ 7.5%

Which of the following statements, do you think are applicable to the underlying pathophysiology of a T2DM patient of Indian origin? *

Higher beta cell dysfunction

Impaired GLP-1/GIP secretion

Higher DPP - 4 activity

Decreased adiponectin and Increased inflammatory markers.

Which of the following events, do you think are applicable to the underlying pathophysiology of a T2DM patient of Indian origin? *

Faster disease progression i.e. from pre-diabetes to diabetes

Higher abdominal obesity

Increased risk for cardio-renal complications

Persistent hyperglycemia (HbA1C >7.5%)

In your practice what percentage (%) of newly diagnosed patients receive modern OADs like DPP4i, SGLT2i & GLP-1 RA? *

10 – 25%

25 – 50%

≥ 50%

≥ 75%

100%

In your clinical practice, what percentage of patients are prescribed the older OADs, e,g, SUs, SU + Met, Pioglitazone, AGI? *

11 – 25%

25 – 50%

≥ 50%

≥ 75%

100%

Which of the modern OADs do you regularly prescribe in the newly or recently diagnosed T2DM patients in your clinical practice? *

DPP- 4 inhibitors

SGLT2-i

GLP-1 Receptor agonist

Other

In the case of a T2DM patient uncontrolled on Metformin, which drug do you prefer as an add-on? *

DPP- 4 inhibitors

Sulphonylurea

Pioglitazone

SGLT2-i

Which of the DPP- 4 Inihibitors you commonly prescribe? *

Sitagliptin

Linagliptin

Vildagliptin

Teneligliptin

How do you rank DPP-4 Inhibitors in terms of efficacy? *

Sitagliptin

Linagliptin

Vildagliptin

Teneligliptin

Which type of T2DM patients generally prescribe Sitagliptin? *

Newly diagnosed.

Uncontrolled/ Intolerant to Metformin

Patients on Insulin

As an add-on to other therapies

How do you prefer to prescribe Sitagliptin? *

As a monotherapy

In combination with Metformin

In combination with Insulin

In combination with SGLT2-is

Other

In your clinical practice, where do you place Sitagliptin in the therapy for T2DM management? *

As a first line drug

As a first line in combination with Metformin

As a second line drug

As a third line drug

As an add-on in case of uncontrolled glycemia

Which pathological aspect(s) of Sitagliptin as a drug is important in your regard to influence the outcomes in a T2DM patient? (Can select multiple option) *

Improves the Beta-cell function and Insulin secretion

Improves endothelial dysfunction

Prevents micro-vascular complications

Helps in reducing the progression of macro-vascular complexities

Which parameter of Sitagliptin as a drug is important for beneficial outcomes in a T2DM patient? (Can select multiple option) *

Effectively reduces HbA1c

Is weight neutral

Reduced risk of Hypoglycemia

Higher tolerability; reduced side effects

Improved treatment adherence and patient compliance

What parameter(s) is most important to you, while choosing to add Sitagliptin to the existing therapy? (Can select multiple option) *

HbA1c level

Age of the patient

Duration of diabetes

Co-morbidities

Treatment adherence

Do you prefer to use Sitagliptin as a monotherapy? *

Yes

Sometimes

Do you prefer to prescribe Sitagliptin in patients with renal impairment? *

Yes

Depends on the patient condition

Do you perceive Sitagliptin to be safe in patients with pre-existing cardiovascular disease? *

Yes

Depends on the patient condition

The NICE NG 28 and IDF guidelines recommend DPP- 4 Inhibitors as first line therapy, especially in Metformin intolerant patients. Do you use DPP - 4 Inhibitors as first line therapy in such patients? *

Yes

If answer to Q25 is YES, please specify which DPP - 4 Inhibitors?

Sitagliptin

Linagliptin

Vildagliptin

Teneligliptin

If answer to Q25 is NO, please specify which other class of drugs you prefer?

SGLTs Inhibitors

GLP-1 Receptor agonist

Sulphonylurea

Pioglitazone

Do you prescribe Sitagliptin with Insulin in your patients? *

Yes

If answer to Q28 is YES, please specify the main reason(s) for using this combination.

Decreased risk of Hypoglycemia

Decreased BMI

Decreased Insulin Resistance

Improved glycemic control

Better HbA1c reduction

If answer to Q28 is NO, please specify which other class of drugs you prefer in combination with Insulin?

SGLTs Inhibitors

GLP-1 Receptor agonist

Sulphonylurea

Pioglitazone

In recently diagnosed T2DM patients, do you think use of DPP4i will offer added benefits over SU? *

Yes

Can’t say

Which type of co-morbidity/ condition do you prefer to prescribe Sitagliptin in? *

Renal Impairment

Hepatic Impairment

Cardiovascular disease

Elderly patients

How do you perceive the safety and tolerability of Sitagliptin? *

Good

Comparable to other therapies

Higher side effects

Can’t say

It is seen clinically that early intervention with sitagliptin in patients with T2DM may have long-lasting reno-protective and islet-protective effects. Do you agree with this evidence? *

Yes

Can’t say

Do you believe durable control is important parameter to consider along with efficacy in recently diagnosed T2DM patient? *

Yes

Can’t say

If answer to Q35 is yes, which DPP4i do you perceive to have a long term durable control?

Sitagliptin

Vildagliptin

Linagliptin

Clinical evidence suggests that Sitagliptin reduces glycemic parameters within 7 days. Do you agree to this observation? *

Yes

Can’t say

Sitagliptin shows 91.7% DPP- 4 inhibition. Does this influence your preferance for Sitagliptin in your patients? *

Yes

Can’t say

Sitagliptin along with Metformin reduces HbA1c levels by 3.6% in newly diagnosed T2DM patients with high baseline HbA1c. Have you witnessed this in your clinical practice? *

Yes

Can’t say

Do you get desirable response relevant to the clinical evidence in your practice when prescribing Sitagliptin? *

Yes

Can’t say

What key points should be highlighted in the promotion of ISTAVEL for managing recently diagnosed T2DM patient? (Subjective question) *