Glycaemic durability and compliance among type 2 diabetes mellitus patients from India: results from the companion survey
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20243637Keywords:
Type 2 diabetes mellitus, Adherence, Compliance, Time in range, Continuous glucose monitoringAbstract
Background: The COMPANION research survey was conducted to understand glycemic durability and compliance with existing care among type 2 diabetes mellitus (T2DM) patients in India.
Methods: The cross-sectional observational survey enrolled 367 physicians; each physician responded to a questionnaire based on observation of 15 T2DM patients in their clinical practice and overall clinical experience. The survey questionnaire consisted of 6 sections with questions on durability of glycemic control, treatment adherence, patient compliance and time- in-range (TIR).
Results: Most physicians agreed that durability of glycemic control was an important factor for better clinical outcomes. More than half of the physicians believed that glycemic control was determined by medication adherence, lifestyle modifications, class of antidiabetic drugs, and duration of diabetes. Along with a weight neutral effect, physicians opined that vildagliptin exhibited reduced risk of hypoglycemia. Stopping medications after feeling better and trouble in swallowing tablets were the two main reasons for medication non-adherence. EAZYGLIDE™ tablet, a fixed-dose combination of vildagliptin plus metformin, was found to improve patient adherence and compliance. In patients with poor TIR, around 76% of physicians recommended dipeptidyl peptidase-4 inhibitor therapy. In all, 87% of physicians prescribed ambulatory glucose profile (AGP) to patients with increased risk of hypoglycemia.
Conclusion: Appropriate evaluation of glycemic control plays a vital role in the overall management of T2D. EAZYGLIDE™ tablet exhibited improved patient adherence and compliance to therapy owing to its improved features. Patient education about continuous glucose monitoring and AGP and prescription of suitable medications are necessary for enhancing overall clinical outcomes.
References
Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes research and clinical practice. 2022;183:109119.
Anjana RM, Unnikrishnan R, Deepa M, Pradeepa R, Tandon N, Das AK, et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). The Lancet Diabetes & Endocrinol. 2023;11(7):474-89.
Das AK, Mohan V, Joshi S, Shah S, Zargar AH, Kalra S, Unnikrishnan AG, Kumar A, Mithal A, Tandon N. IMPACT India: a novel approach for optimum diabetes care. J Diabetol. 2021;12(3):239-45.
Borgharkar SS, Das SS. Real-world evidence of glycemic control among patients with type 2 diabetes mellitus in India: the TIGHT study. BMJ Open Diabetes Res Care. 2019;7:654.
Davies MJ, Aroda VR, Collins BS, Gabbay RA, Green J, Maruthur NM, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes care. 2022;45(11):2753-86.
Matthews D, Del Prato S, Mohan V, Mathieu C, Vencio S, Chan JC, et al. Insights from VERIFY: Early combination therapy provides better glycaemic durability than a stepwise approach in newly diagnosed type 2 diabetes. Diabetes Ther. 2020;11:2465-76.
El Sayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Glycemic targets: standards of care in diabetes—2023. Diabetes Care. 2023;46(1):97-110.
Unnikrishnan AG, Saboo B, Joshi S, Kesavadev J, Makkar BM, Agarwal S, et al. Consensus statement on use of ambulatory glucose profile in patients with type 2 diabetes mellitus receiving oral antidiabetic drugs. J Assoc Physicians India. 2019;67:76-83.
Kalra S, Gupta Y. Ambulatory glucose profile: Flash glucose monitoring. J Pak Med Assoc. 2015;65:1360-2.
Gabbay MA, Rodacki M, Calliari LE, Vianna AG, Krakauer M, Pinto MS, et al. Time in range: a new parameter to evaluate blood glucose control in patients with diabetes. Diabetol Metab Syndr. 2020;12:1-8.
Fernandez-Lazaro CI, García-González JM, Adams DP, Fernandez-Lazaro D, Mielgo- Ayuso J, Caballero-Garcia A, et al. Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study. BMC Fam Pract. 2019;20:132.
Garcia-Perez LE, Álvarez M, Dilla T, Gil-Guillén V, Orozco-Beltrán D. Adherence to therapies in patients with type 2 diabetes. Diabetes Ther. 2013;4:175-94.
Christofides EA. Practical insights into improving adherence to metformin therapy in patients with type 2 diabetes. Clin Diabetes. 2019;37:234-41.
Hofmanová JK, Rajabi-Siahboomi A, Haque S, Mason J, Teckoe J, To D, et al. Developing methodology to evaluate the oral sensory features of pharmaceutical tablet coatings. Int J of Pharm. 2019;562:212-7.
Bode BW. Defining the importance of daily glycemic control and implications for type 2 diabetes management. Postgrad Med. 2009;121:82-93.
Schroeder EB. Management of type 2 diabetes: selecting amongst available pharmacological agents. Endotext. 2022. Available at: https://pubmed.ncbi.nlm. Accessed on 17 August 2024.
Pan C, Wang X. Profile of vildagliptin in type 2 diabetes: efficacy, safety, and patient acceptability. Ther Clin Risk Manag 2013;9:247-57.
Polonsky WH, Henry RR. Poor medication adherence in type 2 diabetes: recognizing the scope of the problem and its key contributors. Patient Prefer Adherenc. 2016;10:1299-307.
DiBonaventura M, Wintfeld N, Huang J, Goren A. The association between nonadherence and glycated hemoglobin among type 2 diabetes patients using basal insulin analogs. Patient Prefer Adherence. 2014;8:873-82.
1. Center for Drug Evaluation and Research. Size, shape, and other physical attributes of generic tablets and caps. Available at: https://www.fda.gov/regulatory. Accessed on 12 August 2024.
Ajjan R, Slattery D, Wright E. Continuous glucose monitoring: A brief review for primary care practitioners. Adv Ther. 2019;36:579-96.
Engler R, Routh TL, Lucisano JY. Adoption barriers for continuous glucose monitoring and their potential reduction with a fully implanted system: Results from patient preference surveys. Clin Diabetes 2018;36:50-8.
