Early Therapeutic Intensification and Glycaemic Variability Control With Gliclazide in Type 2 Diabetes Mellitus: A National Kap Survey of Indian Physicians.

Background: Prompt pharmacological escalation and rigorous management of glycaemic variability (GV) slow the natural history of type 2 diabetes mellitus (T2DM). Nevertheless, therapeutic inertia, logistical hurdles and patient-related barriers frequently delay treatment intensication. Gliclazide—a modern sulfonylurea—combines robust glucose-lowering efcacy with a low hypoglycemia liability at modest cost. Objective: To characterize Indian endocrinologists' and diabetologists' knowledge, attitudes, and practices (KAP) concerning early intensication and GV control with gliclazide in newly diagnosed or sub-optimally controlled T2DM. A 20-item, web-b Methods: ased questionnaire was circulated nationally between January and March 2025. Responses from 567 specialists were accumulated and analyzed descriptively. Results: Baseline HbA1c guided initial therapy for 58.8% of clinicians, whereas 21% prioritized co-existing morbidities. Clinical guidelines represented the principal knowledge source for 54.2% of respondents. Follow-up intervals of 1–3 months were favored by 64.5%. Major hurdles to timely intensication comprised poor patient adherence (60.4%), inadequate consultation time (16.8%), and waning engagement (14.3%). Although 71% reported strict adherence to peer guidelines, implementation gaps persisted. Indian diabetes special Conclusions: ists are well versed in guideline directives, yet systemic constraints and therapeutic inertia undermine consistent application. Wider deployment of continuous glucose monitoring, structured education programs, and pragmatic use of gliclazide could mitigate these shortcomings.