Uday Phadke, Jayashree Gopal, Kaushik Biswas, Priyanka Joshi, Ashish Prasad, Ashish Birla

ADMIRE Study: Dapagliflozin and Metformin Fixed-dose Combination as Initial Choice of Therapy in Type 2 Diabetes Mellitus: A Real-world Study

Abstract Introduction: The use of sodium-glucose cotransporter 2 inhibitors with metformin has become one of the preferred therapies for the management of Type 2 diabetes mellitus (T2DM). In this study, we assessed prescribing patterns in T2DM patients who were initiated dapagliflozin and metformin (Dapa-Met) as initial choice fixed dose combination (FDC). We assessed the indications for choosing Dapa-Met FDC and changes in cardiometabolic parameters. Methods: In this retrospective analysis, we included T2DM patients with hemoglobin A1C (HbA1C) >7% who were initiated with Dapa-Met FDC as initial treatment. Data HbA1C, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), weight, systolic blood pressure (BP), and diastolic BP were recorded after 6 months of Dapa-Met FDC. Results: In total, data from 485 T2DM patients (mean age: 59.7 ± 9.8 years) were included. The mean duration of diabetes was 6.9 ± 4.7 years. For Dapa-Met FDC, 10 mg and 500 mg were the most preferred strengths. Nearly, 78% of patients required additional antidiabetic drug. Sulphonylureas (50.7%) and dipeptidyl peptidase 4-inhibitors (36.7%) were the most common co-prescribed drugs. Besides glycemia control, Dapa-Met FDC was preferred for weight loss (77.1%) and reducing cardiovascular events and related hospitalizations (46.8%). After 6 months, changes in HbA1C (D - 2.19%, P < 0.0001), FPG (D - 21.4 mg/dL, P < 0.0001), and PPG (D - 37.1 mg/dL, P < 0.0001) were significant. Hypoglycemic events (16.7%) and genitourinary infections (8.9%) were the common adverse events. Conclusion: Dapa-Met (10/500 mg) as FDC is effective and safe in Indian patients with T2DM when used as an initial choice treatment for T2DM. Additional antidiabetic therapies may be necessary to achieve glycemic targets.

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