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SMART 3.0: Selection of therapies and understanding coMbination treAtment appRoaches in Type 2 diabetes

Survey Questionnaire Form
Doctor's details
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Questionnaire

  1. Among your diabetic patients, what percentage of patients are prescribed the fixed-dose combination of Dapagliflozin and Sitagliptin? *

  2. For your diabetic patients, what percentage are prescribed the fixed-dose combination of Dapagliflozin, Sitagliptin, and Metformin? *

  3. when will you initiate combination therapy for a newly diagnosed type 2 diabetes patient, and please mention the factors influencing your choice of drugs? *
  4. In treatment-naïve type 2 diabetes patients with HbA1c levels between 8.5-10%, which of the following initial therapeutic regimens do you consider optimal? *

  5. When intensifying treatment from Metformin monotherapy, which add-on pharmacologic agent do you perceive as providing the most durable glycemic control with minimal adverse effects? *

  6. For each DPP4i + SGLT2i combination below, specify the patient phenotypes or clinical characteristics that will be suitable for selection *
    7. Sitagliptin + Dapagliflozin
    Linagliptin + Dapagliflozin
    Vildagliptin + Dapagliflozin
    Linagliptin + Empagliflozin
  7. What are the primary clinical challenges you do encounter when managing patients on triple-drug anti-diabetic therapy like dapagliflozin + glimepiride + metformin FDC, and how do you mitigate these complexities in practice? *
  8. For triple-drug therapy, which of the following Metformin-based regimens do you consider optimal for comprehensive glycemic and metabolic control? *

  9. In which patient profiles would you prefer the Dapagliflozin and Sitagliptin combination, particularly with regard to cardiovascular and renal benefits over the other alternative dual-drug therapies? Please elaborate on the specific benefits observed (e.g., cardiovascular protection, renal safety, etc.). *
  10. When choosing combination therapies for patients with type 2 diabetes and concurrent comorbidities, what factor primarily drives your decision-making? *

  11. In patients with renal impairment, how does the combination of Dapagliflozin and Linagliptin compare in terms of efficacy? Please discuss your rationale, considering renal function parameters, glycemic efficacy, and safety outcomes *
  12. What clinical attributes make the combination of Sitagliptin and Dapagliflozin especially suitable? (Select all applicable) *

  13. Compared to fixed-dose combinations (FDCs) of Empagliflozin + Metformin, how would you evaluate the safety profile of the Dapagliflozin and Sitagliptin combination in your patient population? *

  14. Have you transitioned from any injectable therapies to the Dapagliflozin and Sitagliptin combination? If yes, why?

  15. If a 60-year-old male patient on Dapagliflozin and Sitagliptin (with or without background Metformin) has an eGFR > 60 but has not achieved HbA1c target, which third drug would you consider adding?

  16. In your experience, how long does it typically take to see significant improvements in HbA1c after starting the Dapagliflozin and Sitagliptin combination? *

  17. Under what circumstances would you switch from the Dapagliflozin and Sitagliptin combination to a three-drug FDC? *

  18. Regarding hypoglycemia risk, how does the Dapagliflozin and Sitagliptin combination compared to Metformin and Glimepiride? *

  19. When managing diabetic patients with high cardiovascular risk, what combinations therapies do you prefer? And mention the reasons for the same *
  20. How do you tailor the management of diabetes for elderly patients (>65 years of age) with respect to combination of Dapagliflozin and Sitagliptin? (can select more than one options) *

  21. For patients on Dapagliflozin and Sitagliptin (with or without background Metformin) who have not achieved HbA1c target, which third drug would you consider adding in specific scenarios such as a patient with eGFR = 30, an obese patient (where weight management is a priority), a female patient, or a 75-year-old patient (considering age-related factors)? *

  22. How do you personalize diabetes treatment plans for patients with multiple comorbidities such as cardiovascular disease and chronic kidney disease, particularly considering the risk of genito-urinary infections? How do you factor in the benefits of using Dapagliflozin with Sitagliptin, which may reduce such risks? *
  23. In your experience, what has been the most effective approach to improving patient adherence to combination therapies in type 2 diabetes, especially when selecting three-drug fixed-dose combinations (3FDCs)? Kindly describe any strategies that have worked well *
  24. How do Dapagliflozin and Sitagliptin compare to Dapagliflozin and Linagliptin in terms of long-term efficacy and safety for managing type 2 diabetes, especially regarding blood sugar control, cardiovascular health, and side effects? *
  25. In Metformin intolerance patient with HbA1c >8%; do you prefer to start with a FDC of Dapagliflozin + Sitagliptin! *