Real-World Clinical and Cardio-Renal Outcomes with Dapagliflozin in Type 2 Diabetes: Evidence from Southern India

Background: Managing type 2 diabetes (T2D) is challenging, and doctors often need treatments that help with more than just blood sugar control. Dapagliflozin is one such medication, offering benefits for heart, kidney, and metabolic health. Yet, real-world evidence on dapagliflozin use and perspectives among physicians in India is limited. Therefore, this study aims to understand real-world clinical and cardio-renal outcomes with dapagliflozin in the management of T2D from Southern India.

Methods: A questionnaire-based survey was conducted among physicians in southern India. It comprised 24 questions addressing the use of dapagliflozin in clinical practice and its effect on blood pressure, Hemoglobin A1c (HbA1C), fasting blood glucose, estimated glomerular filtration rate (eGFR), and its overall safety profile. Descriptive analysis was performed, and outcomes were expressed as percentages.

Result: A total of 251 physicians were included in this study. Physicians reported significant clinical benefits from the use of dapagliflozin in routine practice. Most physicians (60.56%) observed an average HbA1c reduction of 1.1-1.5% within three months, with evident glycemic improvement often seen by 2-4 weeks. Combination therapy of dapagliflozin with metformin was common (93.63%). Dapagliflozin was frequently prescribed for adults aged 41-60 years. Among hypertensive patients, more than half of the physicians (60.56%) reported a 5-10 mmHg reduction in blood pressure. According to 60.16% of physicians, the key cardiovascular benefit was a reduction in major adverse cardiac events. Renal observations of physicians (69.72%) reported an initial mild decrease in eGFR followed by stabilization, and improved proteinuria in many patients. Metabolic improvements such as reduced triglycerides and increased high-density lipoprotein cholesterol were also reported (50.60%). Adverse events were infrequent, and most physicians (66.93%) had not encountered diabetic ketoacidosis.

Conclusion: The survey demonstrated that physician’s favour dapagliflozin for managing T2D in a wide range of patients, and it is found to be both effective and well-tolerated in routine practice.