Clinicians' Perspectives on Glycemic Control, Treatment Strategies, and Monitoring in Type 2 Diabetes Mellitus: A Nationwide Survey

Background: Although there are several clinical studies available regarding the management of Type 2 diabetes mellitus (T2DM), there is a dearth of studies among clinical experts on their practice. This study aimed to assess clinicians’ perspectives on the drivers of poor glycemic control, gaps in early screening, treatment choices, use of fixed-dose combinations (FDCs) of dapagliflozin, glimepiride, and metformin, safety considerations, and perceived glycemic outcomes in T2DM. Methodology: This cross-sectional study was carried out among 1,300 Indian clinical experts and utilized a multiple-response questionnaire to assess perspectives on poor glycemic control, screening gaps, and treatment patterns related to FDCs of dapagliflozin, glimepiride, and metformin. Responses were summarized using descriptive statistics and visualized using Microsoft Excel. Results: More than half of the participants (54.46%) identified a sedentary lifestyle and irregular follow-up visits as the principal contributors to poor glycemic control in routine clinical practice. A substantial majority (68.77%) indicated that inadequate awareness of early screening is the primary reason for elevated glycated hemoglobin (HbA1c) levels at diagnosis. Over half of the respondents (52.23%) perceived sulfonylureas to provide superior glycemic durability in clinical settings. Approximately 42% reported multiple factors, namely rapid and sustained glycemic control, reduced pill burden, and cost considerations, as key reasons for the early initiation of combination therapy. Nearly two-thirds of clinicians (63.46%) observed that patients with high baseline HbA1c levels (8–11%) experience the greatest benefit from the FDCs of dapagliflozin, glimepiride, and metformin. Conclusion: Uncontrolled T2DM is primarily driven by a sedentary lifestyle, poor follow-up, and low awareness of early screening. Clinicians favor sulfonylureas for glycemic durability and support early combination therapy for rapid control, improved adherence, and cost considerations. FDCs are perceived to delay insulin initiation, with patients presenting with high baseline HbA1c levels deriving the greatest benefit from the combination of dapagliflozin, glimepiride, and metformin.