Therapeutic Efficacy & Long-term Treatment Outcome of DPP-4 Inhibitors as an add-on Therapy with Metformin and Sulfonylureas in T2DM Patients at GP Clinics of Southern Odisha
Author(s): Premakanta Mohanty, Chinmaya Debasis Panda and Pradyut Kumar Pradhan
Abstract
Introduction: Diabetes is a global health concern with T2DM being the most common type. Medical science has hardly been successful in managing this condition and its associated co-morbidities and complications. Most interestingly although it’s a condition primarily referred to super specialists, it has to be primarily managed by general practioners in primary healthcare setups. GPs face many problems in diabetes management, one of which is non-availability of a universal treatment guideline applicable to all patients. Hence to evaluate individual newer drugs like DPP-4 inhibitors for their efficacy, safety and long-term treatment outcome, this study was conducted. Aim and objective: To provide evidence about the therapeutic efficacy and long-term treatment outcomes in T2DM patients treated with DPP-4 inhibitors as an add-on therapy with metformin and sulfonylureas. Methodology: A sample of 153 T2DM patients with disease duration of around 5 years was selected who were being treated in GP clinics of southern Odisha. Among them around 74 patients were isolated who were taking either a combination of metformin and sulfonylureas (Group-A) or metformin, sulfonylureas and DPP-4 inhibitors (Group-B). Patient past data like their demography, blood glucose level, HBA1C level etc. were collected from their personal treatment files using a structured case record form and was statically evaluated to extract the efficacy with complication and co-morbidity outcomes in patients with and without DPP-4 inhibitors in their treatment regimen. Discussion and conclusion: In our study it was found that DPP-4 Inhibitors significantly improved glycemic outcome (OR, 2.862; 95% CI, 1.349-6.069) as compared to the control group (OR, 0.845; 95% CI, 0.299-2.385). Treatment group had shown relatively better blood pressure control (OR, 0.997; 95% CI, 0.487-2.043) than control group (OR, 0.114; 95% CI, 0.025-0.529). No statistically significant relationship could be established between DPP-4 Inhibitors and any of the chronic complications of T2DM. Further studies are needed to evaluate and establish the findings of our study.