EFFECTIVENESS OF EMPAGLIFLOZIN AND LINAGLIPTIN AS ADD-ON THERAPY TO METFORMIN IN TYPE 2 DIABETES: PHYSICIAN INSIGHTS FROM SOUTHERN INDIA
Abstract
Background: Type 2 diabetes mellitus (T2DM) is a chronic global health burden associated with cardiovascular (CV) and renal complications. This study aimed to evaluate real-world efficacy, cardiometabolic outcomes, and long-term outcomes of the empagliflozin + linagliptin add-on therapy to metformin in T2DM patients. Methods: This questionnaire-based study included physicians from southern India. A 17-item questionnaire assessed efficacy, cardiometabolic outcomes, and the long-term outcome of this combination add-on therapy, focusing on the last 10 patients. Results: A total of 206 physicians from southern India participated. Physicians reported that 1-2 patients had pre-existing cardiovascular disease (37.86%). Additionally, most patients were previously on dual therapy before switching to this combination (32.04%). A significant reduction (≥1%) in glycated haemoglobin (HbA1c) (47.09%) and improved glycaemic control (46.12%) were observed in most patients within 3 months. Compared with other regimens, this combination was more effective in HbA1c reduction (49.51%). Moderate improvements in postprandial glucose control (50.49%) and insulin sensitivity (42.23%) were also reported. Weight loss (>2 kg) within 3 months (33.50%) and improved blood pressure (32.04%) were observed in some patients. In patients with T2DM and heart failure, 45.63% reported moderate symptom improvement, particularly for lipid profiles. Compared to similar regimens, this add-on therapy provided more or equal CV protection (40.78%). Renal function was monitored more frequently by 37.38% of physicians every 6 months. Moderate reductions were observed in long-term diabetes-related complications (43.69%) and associated hospitalisations (48.06%). Conclusion: The empagliflozin + linagliptin add-on therapy to metformin was reported to improve glycaemic and cardiometabolic outcomes and reduce long-term diabetes related complications.