Introduction: The fixed-dose combination (FDC) of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors offers an effective, non-metformin based option for patients with type-2 diabetes mellitus (T2DM) who cannot tolerate metformin. The objective of the study was to address the existing gaps in knowledge about FDC of SGLT-2 inhibitors and DPP-4 inhibitors particularly, the combination of dapagliflozin and sitagliptin FDC and to provide evidence to address these issues. Methods: This cross-sectional, observational, questionnaire-based study was conducted at five round table meetings, which included clinicians from India. A validated questionnaire (of 9 questions) was used to assess clinical views on dapagliflozin and sitagliptin FDC therapy for T2DM management. The opinions and suggestions from all the meetings were compiled and analyzed, to derive the consensus statement. Results: A strong consensus (89.47%) identified efficacy as the key factor for the early initiation of combination therapies for glycemic control. Experts (90.91%) agreed that combining SGLT-2 inhibitors and DPP-4 inhibitors enhances insulin sensitivity. A consensus (55.56%) supported early initiation of dapagliflozin and sitagliptin FDC to reduce hypoglycemia risk. Experts also noted the regimen’s simplicity (59.26%) and, with a majority (78.57%), agreed that it reduces major cardiovascular (CV) events, weight, blood pressure, and heart failure risk while improving the lipid profile. Most experts (80.56%) supported the early use of dapagliflozin and sitagliptin FDC in T2DM patients with CV risk. Conclusion: The consensus strongly indicates that early initiation of dapagliflozin and sitagliptin FDC therapy improves glycemic control, reduces CV events, and enhances patient outcomes.
Unnikrishnan et al. (Tue,) studied this question.