Objective: The survey aimed to assess clinicians’ perspectives and preferences in managing type 2 diabetes mellitus (T2DM), with particular emphasis on cardiovascular risk–based decision-making and the use of dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose co-transporter-2 (SGLT2) inhibitors in routine clinical practice. Methodology: This cross-sectional study was conducted among clinicians across India to assess clinical perspectives in the management of T2DM with cardiovascular risk, heart failure (HF), and chronic kidney disease (CKD). A structured 22-item, multiple-response questionnaire was distributed via digital platforms, and responses were analyzed using descriptive statistics to summarize clinician preferences and experiences.
Results: A total of 366 clinicians participated in the survey. Nearly 34% of clinicians identified the combination of a DPP-4 inhibitor, an SGLT2 inhibitor, and metformin as their preferred initiation therapy for newly diagnosed individuals with T2DM and cardiovascular risk. Approximately 80% of respondents reported sitagliptin as their preferred DPP-4 inhibitor. Around 70% of clinicians favored switching to a triple combination of metformin, a DPP-4 inhibitor, and an SGLT2 inhibitor in patients inadequately controlled on sulphonylurea plus metformin therapy. Among newly diagnosed individuals with T2DM and HF, 49% preferred the combination of a DPP-4 inhibitor, an SGLT2 inhibitor, and metformin as the oral antidiabetic regimen. Nearly 86% of participants favored dapagliflozin as the preferred SGLT2 inhibitor in patients with established HF.
Conclusion: This survey indicates that clinicians frequently encounter individuals with T2DM presenting with cardiovascular risk. Physicians predominantly favor combination regimens incorporating DPP-4 inhibitors and SGLT2 inhibitors due to their perceived benefits in achieving glycemic targets, reducing glycemic variability, and providing cardiovascular and renal protection.