An Observational Study on the Comparative Analysis of Monotherapy Versus Combination Therapy in Type 2 Diabetes Mellitus Patients at a Tertiary Care Hospital in Eastern India

Abstract Introduction: Type 2 diabetes mellitus (T2DM) is a major global health concern, affecting nearly half a billion individuals and contributing significantly to morbidity and mortality. It is characterized by chronic hyperglycemia due to insulin resistance and/or impaired insulin secretion. Effective glycemic control through lifestyle modification and pharmacotherapy is critical to prevent complications. This study compares the efficacy and patterns of monotherapy versus combination therapy in T2DM management. Materials and Methods: This cross-sectional observational study was conducted in the General Medicine Outpatient Department (OPD) and Department of Pharmacology, Calcutta National Medical College, Kolkata (July 2022–September 2023). A total of 150 patients with T2DM aged >18 years were enrolled using convenience sampling. Data on demographics, comorbidities, drug regimens, renal function (estimated glomerular filtration rate [eGFR]), and glycemic control (HbA1c) were collected. Analysis was performed using SPSS; significance was set at P < 0.05. Results: Of the 150 patients, 6.67% were on monotherapy and 93.33% on combination therapy. The mean duration of diabetes and body mass index (BMI) were significantly higher in the combination therapy group ( P = 0.01 and 0.02, respectively). Triple therapy (41.33%) was the most common, followed by dual (31.33%) and polytherapy (20.67%). Metformin was the most prescribed drug (85.33%), followed by teneligliptin (63.33%). Insulin use increased with rising HbA1c levels, reaching 71.43% in patients with HbA1c >10%. Conclusion: Combination therapy is widely used in T2DM patients with longer disease duration and higher BMI. Treatment choice closely correlates with HbA1c levels, indicating adherence to American Diabetes Association (ADA) guidelines. Insulin is appropriately intensified for poor glycemic control.