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A survey to collect the Insights on the perception anD usagE of SGLT-2i+DPP-4i in the management of T2DM with cardiac co-morbidities (IDEA)

Survey Questionnaire Form

Doctor's details

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Name of Doctor *

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Name of Doctor *

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Age *

Gender *

Male Female

Doctor’s Degree*

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Speciality *

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Speciality*

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City*

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City*

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Predominant type of practice*

Multi-specialty hospital

Clinic/ nursing home

Government hospital/ medical college

Mixed

Questionnaire

Please tick the right option & in case of few questions you can tick more than one option

In your clinical practice which is the most common comorbidity associated with diabetes? (Multiple Answers can be ticked) *

Chronic kidney disease

Hypertension

Cardiovascular disease

Dyslipidaemia

Obesity

Diabetic neuropathy

Diabetic retinopathy

Diabetic foot

Any Others

When it comes to cardiac comorbidities, which of the following condition is seen most commonly among uncontrolled T2DM patients? *

Hypertension

Coronary artery disease

Cardiac arrythmias

Heart Failure

As per a study published in BMC Medicine1, 4 out 5 patients with T2DM will develop CVD or CKD in the future. Do you agree with this finding? *

Yes

In your practice what % of patients with heart failure have diabetes as co-morbidity? *

<10%

11-25%

26-50%

>50%

What is the target HbA1C level in diabetic patients with cardiac co-morbidities? *

<7%

7-8%

8-9%

>9%

What is your perspective that CKD and CVD progression in T2D is driven by which pathophysiological factors? *

Metabolic factors

Hemodynamic factors

Inflammatory and fibrotic factors

All of the above

Recent ADA-EASD Consensus statement 2022 highlights on early intensification of OAD therapy with newer OADs - Do you agree with this strategy to manage your T2DM patients? *

Yes

With such a high burden of comorbidities with T2DM, what according to you should be the goal of diabetes treatment? *

Aggressive glycemic control reduction

Aggressive glycemic control with cardiac and renal risk

What % of your patients are on following number of antidiabetic agents/drugs (OAD) in your clinical practice? *

1 agent	%
2 agents	%
3 agents	%
≥3 agents and/or insulin	%

Which is the preferred drug or combination of drugs used for managing uncontrolled T2DM patients with cardiac comorbidities? *

Metformin/SU/SU +Metformin

Newer OADs like SGLT-2i & DPP-4i

SGLT-2i+DPP-4i Fixed Dose Combination

GLP-1 RA/Insulin

What is the single-most benefit that you observe when initiating your patient on a FDC at the start of the therapy? *

Faster glycemic control

Slows the progression of underlying co-morbidities (CV, renal, etc.)

Reduced progression of micro-vascular complications

Improved compliance and adherence to treatment

What will be your order of preference of SGLT-2i+DPP-4i FDC in T2DM patients with CV co-morbidity or at-risk of CVD? Please rank among the following combinations (1 - Most preferred >>>> 6 - Least preferred) *

Preference (1-6)

Teneligliptin + Dapagliflozin
Empagliflozin + Linagliptin
Sitagliptin + Dapagliflozin
Remogliflozin + Vildagliptin
Vildagliptin + Dapagliflozin
Saxagliptin + Dapagliflozin

In your clinical practice, in what percentage of T2DM patients with cardiac comorbidities would you prefer using Sitagliptin and Dapagliflozin FDC? *

<10%

11-25%

26-50%

>50%

For patients with cardiac co-morbidities, which is the preferred strength of Sitagliptin and Dapagliflozin FDC in your clinical practice? *

Sitagliptin 100 + Dapagliflozin 10

Sitagliptin 50 + Dapagliflozin 10

Sitagliptin 100 + Dapagliflozin 5

Sitagliptin 50 + Dapagliflozin 5

Please mention the lowest value of eGFR, where you use Dapagliflozin and Sitagliptin FDC in type 2 diabetes patient? *

Only if eGFR is ≥ 60 ml/min

If eGFR is 60-45 ml/min

If eGFR is ≤ 45 ml/min

If eGFR is ≤ 30 ml/min but there is no immediate need for dialysis

For which of the following conditions in your practice dose of SGLT2 inhibitor is lowered commonly? *

Urinary Tract Infection

Hypoglycemia

Renal insufficiency

Any Other

What are the advantages of using Sitagliptin and Dapagliflozin FDC over other SGLT-2i+DPP-4i FDCs among T2DM patients with cardiac co-morbidities? *

Established & documented evidence of Sitagliptin & Dapagliflozin in cardiac comorbid T2DM patients

Ease of dose titration (multiple strengths available)

Reduced pill burden & availability

All of the above

In which of the following profile of patients (with T2DM) would you not mind using a FDC of Sitagliptin Dapagliflozin? (Multiple options can be chosen) *

HFrEF with EF ≤ 40%

NYHA functional class II to IV

Patients on standard CVD therapy (like β-blockers/ACEi/ARB/ARNI/MRAs)

In your clinical practice, how often you see hypoglycemic events in T2DM patients using FDC of Sitagliptin Dapagliflozin? *

None

1-5%

6-10%

> 10%

In your clinical practice, the use of Sitagliptin and Dapagliflozin FDC has replaced which other OAD class/molecule? *

Metformin

SU/SU+Metformin

DPP4i/DPP4i+Metformin

In which patients do you recommend the use of continuous glucose monitoring (CGM)? (multiple options can be selected) *

In patients having wide glucose excursions

Patients having uncontrolled HBA1c despite being on multiple antihyperglycemic agents

In Type 1 diabetes patients

In patients having recurrent episodes of hypoglycemia and receiving insulin

Please provide your feedback for use of Sitagliptin and Dapagliflozin FDC, I will prefer to initiate Sitagliptin and Dapagliflozin FDC in my T2DM patients with *

Please specify

While prescribing a FDC of SGLT-2i+DPP-4i to your patients, do you mention some precautions/advises that the patient should follow while on therapy? *

Yes

Kindly provide specific patient profiles in whom SGLT2i and DPP4 inhibitors are administered concomitantly in your clinical practice? *

What are the benefits of fixed dose combinations of SGLT2i and DPP4 inhibitors as against administering them separately in your clinical practice? *

What are the instructions or advices given to the patients to maintain the GU hygiene in your clinical practice? *

What is the frequency of screening for kidney function in T2DM patients and what are investigations recommended for screening in your clinical practice? *

When do you suspect reduced ejection fraction or heart failure in T2DM patients and what are the investigations recommended for the diagnosis in your clinical practice? *

Do you administer fixed dose combination of SGLT2i and DPP4 inhibitors in obese T2DM patients and what are the benefits you notice in your clinical practice? (at least provide 3 benefits) *

Please provide the benefits of diabetic specific nutrition in your T2DM patients? *