Real-world insights on cardiometabolic, glycemic, and safety outcomes of dapagliflozin-based therapy in patients with type 2 diabetes

Background: Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder requiring combination therapy for optimal control. Dapagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, offers added metabolic and cardiovascular benefits with other oral antidiabetic agents. This study aimed to assess healthcare professionals’ (HCPs) real-world experience with dapagliflozin-based regimens in Indian patients with T2DM, focusing on glycaemic outcomes, metabolic benefits, and safety.

Methods: This multicentre, questionnaire-based study was conducted among 104 HCPs, including endocrinologists, diabetologists, and general physicians across India. The structured 17-item questionnaire assessed patient demographics, comorbidities, dietary compliance, glycaemic control, HbA1c reduction with various combination therapies, weight changes, adverse events, and treatment adjustments based on the last 10 patients managed by each HCP. Descriptive analysis was performed, and outcomes were expressed as percentages.

Results: Most HCPs (63.46%) reported that their patients were older than 55 years, and 60.58% had diabetes for more than three years. Chronic kidney disease (40.38%) and dyslipidaemia (31.73%) were the most common comorbidities. Nearly half of the HCPs (48.08%) reported an HbA1c reduction of 1.25%-1.5% with dapagliflozin (10 mg) and vildagliptin (100 mg). The triple combination of dapagliflozin, vildagliptin, and metformin showed similar efficacy. Most HCPs (77.88%) reported no significant side effects, with minimal discontinuations (72.12%) and infrequent hypoglycaemic episodes. Additionally, 66.35% observed weight reduction in 6-10 patients receiving dapagliflozin-based therapy.

Conclusion: Dapagliflozin-based combinations are well tolerated and effective for glycaemic control and metabolic improvement in Indian T2DM patients. Vildagliptin and metformin combinations were preferred for those with high HbA1c and cardiovascular risk. These findings support the safety and utility of dapagliflozin regimens, though larger studies are needed for validation.