Expert Opinion on Managing Uncontrolled Type 2 Diabetes, with a Special Emphasis on the Use of Dapagliflozin-based Fixed Dose Combinations in the Indian Clinical Settings

Abstract Objective: To evaluate clinicians’ perspectives on the prevalence, contributing factors, and management strategies for uncontrolled type 2 diabetes mellitus (T2DM), with a focus on the use of dapagliflozin-based fixed-dose combinations (FDCs) in the Indian setting. Methodology: The cross-sectional study employed 23 questions focusing on clinicians’ views regarding uncontrolled T2DM and the role of dapagliflozin-based FDCs in improving glycemic, cardiovascular, and renal outcomes. Data analysis was conducted using the descriptive statistics. Results: The survey included responses from 464 clinicians. A significant proportion (89.01%) identified multiple contributing factors to uncontrolled T2DM, such as lack of physical activity, poor medication adherence, and irregular follow-ups, often influenced by economic challenges. The vast majority (93.75%) emphasized the importance of regular counseling, follow-up, and periodic glycemic monitoring. Nearly 65% of clinicians preferred combining a dipeptidyl peptidase-4 inhibitor with dapagliflozin. Around 84% recognized that the vildagliptin + dapagliflozin FDC offers multiple benefits, including improved glycemic control, reduced cardiovascular and renal risks, and enhanced adherence. Approximately 46% of the experts highlighted the complementary mechanism and glycemic efficacy of the glimepiride + metformin + dapagliflozin combination, with 74% favoring metformin 500 mg ER. About 41% of clinicians observed a 1–2 kg weight reduction, while 49% noted a 5–7 mmHg reduction in systolic blood pressure (SBP) with dapagliflozin-based FDCs. Conclusion: The survey findings underscore the key challenges such as poor adherence and economic limitations in T2DM management. Clinicians favored dapagliflozin-based FDCs, especially with glimepiride and metformin, for their potential to achieve better glycemic control, promote weight loss, and offer cardiorenal protection.