Insights in Management of Type 2 Diabetes (IMD): A Pan India Survey

Background: Different classes of oral anti-diabetic drugs are available. Management of diabetes is also individualised depending on doctor and patient.

Objective: The objective of the survey was to understand the insights in the management of diabetes in the real world Indian scenario and preference in second choice of oral anti-diabetic drug.

Method: 350 physicians/diabetologist all over India participated in the questionnaire based survey from January 2014 to April 2014. The questions were related to the current prescription patterns of doctors in management of type 2 diabetes and drug preferences and goals in management of type 2 diabetes mellitus.

Results: 91.4% doctors preferred metformin as the first oral agent in pharmacotherapy of type 2 diabetes mellitus. 83.8% preferred sulphonylurea as the second agent in combination with metformin, glimepiride (92.4%) being the preferred sulphonylurea. 25.1% considered addition of second agent when HbA1c > 7%, while 36.7% considered when HbA1c was > 7.5% and 35.8% considered second agent after HbA1c > 8%. 53% doctors directly started dual drug combination treatment when the HbA1c of patients is ≥ 9%.

Conclusion: Metformin is the initial agent in management of diabetes while the second drug in treatment is sulphonylurea with glimepiride being the preferred agent. Significant patient populations do not achieve their HbA1c goals on monotherapy. It is important to avoid clinical inertia in treatment of type 2 diabetes for patients to achieve adequate glycaemic control.