Characterization of Treatment Intensified (Add-on to Metformin) Adults with Type 2 Diabetes: Real-world Clinical Experience (Cardiovascular Outcomes and Value in the Real-world with Glucagon-like Peptide-1 Receptor Agonists) from India in 2008 to 201

Objective: The cardiovascular outcomes and value in the real world with GLP-1 receptor agonists study characterized demographics and medication usage patterns in treatment intensified (add-on to metformin) adults with type 2 diabetes (T2D) in India. Materials and Methods: This study was a retrospective, real-world analysis of data extracted from medical records at five healthcare centers across India during the study period (January 30, 2008–December 31, 2017). Data were collected at 6/12 months before baseline in the overall population and among subgroups defined by glucose-lowering agent (GLA) classes; summarized descriptively. Results: Data from 1000 adults were collected in reverse chronological order. At baseline, the mean age, glycated hemoglobin (HbA 1c ), T2D duration, and body mass index (BMI) of the study population were 51.4 years, 7.9%, 2.6 years, and 27.7 kg/m 2 , respectively. Overall, 81.4% of patients received one GLA and 71.4% had HbA 1c ≥7.0%. Among the subgroups, patients in sulphonylurea subgroup were older (52.5 years), those in glucagon-like peptide-1 receptor agonists (GLP-1RA) subgroup had higher BMI (35.9 kg/m 2 ), and, those in insulin subgroup had higher HbA 1c (9.5%); most frequently prescribed GLA postmetformin was dipeptidyl peptidase-4 inhibitors (42.7%). The utilization of GLP-1RAs/sodium-glucose cotransporter-2 inhibitors was low ( n = 10 and 145, respectively). Among the subgroups, receiving ≥3 GLAs was more common in the GLP-1RA subgroup. Conclusion: Glycemic control in Indian patients with T2D remains inadequate, with underutilization of GLAs with cardiovascular (CV) benefits. Further studies are needed to better estimate CV disease risk in this population and to grasp the reasons for underutilizing GLAs for relevant comorbidities. Trial registration: NCT05542420.