PHYSICIAN-REPORTED EXPERIENCE WITH DAPAGLIFLOZIN IN TYPE 2 DIABETES: EVIDENCE FROM SOUTHERN INDIA
DOI:
https://doi.org/10.22376/ijlpr.v16i1.2027Keywords:
Glycemic control, sodium-glucose cotransporter 2, cardioprotective, adverse events, combinationAbstract
Background:Type 2 diabetes mellitus (T2DM) is associated with microvascular and macrovascular complications, contributing substantially to the global disease burden. This study aimed to evaluate the real-world safety, efficacy,and prescribing patterns of dapagliflozin in T2DM managementto support tailored diabetes care.
Methods: This questionnaire-based study included a 12-item questionnaire that evaluated physicians' perspectives and prescribing patterns related to dapagliflozin, with a specific focus on their last 10 patients with T2DM.
Results: A total of 251 physicians from southern India participated. Nearly half (44.22%) reported initiating dapagliflozin in 3-5 of their last 10 elderly patients (≥65 years). Dapagliflozin was most commonly preferred for patients with CKD (28.69%), followed by those with poor glycemic control or cardiovascular disease (27.49%). Adherence was high with 62.55% noting that 9-10 patients continued therapy for at least six months, cost was the main reason for discontinuation (41.43%). Most physicians (37.45%) reported no major concerns in elderly patients. Among female patients, 0-2 out of 10 experienced urinary tract infections (52.99%). Nearly half (47.01%) felt their patients were very satisfied with dapagliflozin. Cardiovascular protection (33.07%) and glycemic control (29.08%) were the main reasons for prescribing, and metformin was the most common add-on therapy (59.36%). Physicians also reported glycemic efficacy comparable to other sodium-glucose co transporter 2 (SGLT2) inhibitors (42.23%) and cardiovascular benefits comparable to glucagon-like peptide-1(GLP-1) receptor agonists (49.40%). Most (55.38%) expressed a high likelihood of prescribing it in the future.
Conclusion: Physicians prefer dapagliflozin as an effective agent for both monotherapy and combination therapy in T2DM management.
References
Lu X, Xie Q, Pan X, Zhang R, Zhang X, Peng G, et al. Type 2 diabetes mellitus in adults: pathogenesis, prevention and therapy. Signal transduction and targeted therapy. 2024;9(1):262.
Młynarska E, Czarnik W, Dzieża N, Jędraszak W, Majchrowicz G, Prusinowski F, et al. Type 2 diabetes mellitus: new pathogenetic mechanisms, treatment and the most important complications. International journal of molecular sciences. 2025;26(3):1094.
Kumar A, Gangwar R, Ahmad Zargar A, Kumar R, Sharma A. Prevalence of diabetes in India: A review of IDF diabetes atlas 10th edition. Current diabetes reviews. 2024;20(1):105-14.
Rathod L, Khan S, Mishra S, Das D, Bora K, Shubham S, et al. Genetic variants and type 2 diabetes in India: a systematic review and meta-analysis of associated polymorphisms in case-control studies. Lancet Reg Health Southeast Asia. 2024;32:100518.
Vithian K, Hurel S. Microvascular complications: pathophysiology and management. Clin Med (Lond). 2010;10(5):505-9.
Goyal R, Singhal M, Jialal I. Type 2 Diabetes. In: StatPearls. StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513253/.
Mohan V, Makkar BM, Saboo B, Jagadisha A, Chawla M, Deshpande N, et al. Optimizing type 2 diabetes management: the efficacy and safety of gliclazide in clinical practice. J Diabetol. 2025;16(4):308–316.
Munshi MN, Florez H, Huang ES, Kalyani RR, Mupanomunda M, Pandya N, et al. Management of Diabetes in Long-term Care and Skilled Nursing Facilities: A Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(2):308-18.
Zhang L, Ji L, Guo L, Lu J, Tian H, Zhu D, et al. Treatment Patterns and Glycemic Control in Older Adults with Type 2 Diabetes Mellitus Receiving Only Oral Antidiabetes Drugs in China. Diabetes Technol Ther. 2015;17(11):816-24.
Andraos J, Smith SR, Tran A, Pham DQ. Narrative review of data supporting alternate first-line therapies over metformin in type 2 diabetes. Journal of Diabetes & Metabolic Disorders. 2024;23(1):385-94.
St Onge EL, Miller S, Clements E. Sitagliptin/metformin (Janumet) as combination therapy in the treatment of type 2 diabetes mellitus. Pharm Ther. 2012;37(12):699.
Deng S, Zhao H, Chai S, Sun Y, Shen P, Lin H, et al. Influence of early use of sodium-glucose transport protein 2 inhibitors, glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors on the legacy effect of hyperglycemia. Frontiers in Endocrinology. 2024; 15:1369908.
Richardson CR, Borgeson JR, Van Harrison R, Wyckoff JA, Yoo AS, Aikens JE, et al. Management of Type 2 Diabetes Mellitus. Ann Arbor (MI): Michigan Medicine University of Michigan; 2021.
Hinnen D. Glucuretic effects and renal safety of dapagliflozin in patients with type 2 diabetes. Ther Adv Endocrinol Metab. 2015;6(3):92-102.
Zhou Z, Yao X. Safety assessment of dapagliflozin: Real-world adverse event analysis based on the FAERS database from 2012 to 2023. Heliyon. 2024;10(12):e33306.
Dhillon S. Dapagliflozin: A Review in Type 2 Diabetes. Drugs. 2019;79(10):1135-1146.
Gourdy P, Darmon P, Dievart F, Halimi JM, Guerci B. Combining glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2is) in patients with type 2 diabetes mellitus (T2DM). Cardiovasc Diabetol. 2023;22(1):79.
Heerspink HJL, Stefánsson BV, Correa-Rotter R, Chertow GM, Greene T, Hou FF, et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2020;383(15):1436-1446.
McMurray JJV, Solomon SD, Inzucchi SE, Køber L, Kosiborod MN, Martinez FA, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995-2008.
Bak M, Chi SA, Jeon K, Hong D, Shin H, Kim D, et al. Discontinuation rates, clinical effects and provocation factors of SGLT-2 inhibitor in the real world. Scientific Reports. 2024;14(1):30653.
Solomon SD, McMurray JJV, Claggett B, de Boer RA, DeMets D, Hernandez AF, et al. Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction. N Engl J Med. 2022;387(12):1089-1098.
Fioretto P, Mansfield TA, Ptaszynska A, Yavin Y, Johnsson E, Parikh S. Long-Term Safety of Dapagliflozin in Older Patients with Type 2 Diabetes Mellitus: A Pooled Analysis of Phase IIb/III Studies. Drugs Aging. 2016;33(7):511-22.
Nakajima H, Okada S, Mohri T, Kanda E, Inaba N, Hirasawa Y, et al. Dapagliflozin improves treatment satisfaction in overweight patients with type 2 diabetes mellitus: a patient reported outcome study (PRO study). DiabetolMetab Syndr. 2018; 10:11.
Oyama K, Raz I, Cahn A, Goodrich EL, Bhatt DL, Leiter LA, et al. Efficacy and safety of dapagliflozin according to background use of cardiovascular medications in patients with type 2 diabetes: a prespecified secondary analysis of a randomized clinical trial. JAMA cardiology. 2022;7(9):914-23.
Fisher M. Dapagliflozin and DAPA‐HF: from glycaemic control to heart failure therapy. Practical Diabetes. 2019;36(6):192–3.
Sethi B, Sahay R, Tiwaskar M, Negalur V, Dhediya R, Gaurav K, et al. Effectiveness of Dapagliflozin as Add-On to Metformin with or without Other Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus: A Multicentre, Retrospective, Real-World Database Study. Drugs Real World Outcomes. 2024;11(1):81-90.
Phadke DU, Gopal DJ, Biswas DK, Birla DA, Prasad A, Joshi P. FRI649 ADMIRE: Assessing Dapagliflozin And Metformin AsAn Initial Regimen In Diabetes Mellitus For Enhanced Glucose Control. J Endocr Soc. 2023;7(1): bvad114.868.
Velusamy S, Kumar SR. Safety and efficacy of dapagliflozin versus empagliflozin as add-on therapy in type 2 diabetes mellitus management. Indian Journal of Physiology and Pharmacology. 2025;69(2):136.
Riley DR, Essa H, Austin P, Preston F, Kargbo I, Ibarburu GH, et al. All-cause mortality and cardiovascular outcomes with sodium-glucose Co-transporter 2 inhibitors, glucagon-like peptide-1 receptor agonists and with combination therapy in people with type 2 diabetes. Diabetes ObesMetab. 2023;25(10):2897-2909.
Manjula S, M KK. Experts’ perspective on the prescription of dapagliflozin for treating T2DM patients in Indian settings. International Journal of Endocrinology Research. 2025;7(1):22–8.
Published
How to Cite
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
