April 2026, Volume 4, Issue 4

Author

Jnanaprakash B. Karanth, Kiran Maribashetti and Gangapooja J. Karanth

Abstract

Background: Indian Type 2 diabetes mellitus (T2DM) is characterised by premature onset, high prevalence of insulin resistance, and concomitant comorbidities. Timely control of glycemia often calls for multiple drug combinations, but real-world data on treatment, outcomes, and adherence are scarce. Objective: To compare clinical profiles, treatment strategies, glycemic control, drug adherence, and safety outcomes in T2DM patients during a six-month follow-up in the real-world Indian clinical practice. Methods: This was an observational study of 57 adults with T2DM attending an medicine OPD. Patients received one of six fixed-dose triple drug formulations: dapagliflozin-glimepiride-metformin (1A, 1B), sitagliptin-glimepiride-metformin (2A, 2B), or pioglitazone-glimepiride-metformin (3A, 3B). Data on demographics, anthropometry, laboratory values (HbA1c, FBG, PPBG), comorbidities, treatment combinations, adherence, and adverse effects were extracted from medical records across two follow-up visits. Results: The patients' mean age was 58.95 ± 8.24 years, and 57.9% were female. All patients had baseline HbA1c >7.1%, which were highly improved over time; 35.3% had HbA1c ?7.1% by visit 2 (P < 0.0001). The most frequent regimen was 1A + 2A combination with 2 mg Glimepiride. Mean BMI was 23.5 kg/m². The most frequent comorbidity was hypertension (56.1%). Adherence was modestly improved, and adverse events were rare, with hypoglycaemia reduced from 8.8% to 5.3%. Conclusion T2DM patients in this real-world population had significant glycemic control improvements on combination therapy. Enhanced adherence and a low rate of adverse events underscore the practicability of early treatment intensification in Indian clinical practice.