Visual Abstract
Therapy patterns were examined across various subgroups during the first year of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) that included patients with T2D on ≥2 antihyperglycemic medications. Of 6236 patients (mean baseline values - age: 52.1 years, T2D duration: 8.6 years and A1C: 8.05%) enrolled, 5654 completed 1-year follow-up visit. Therapeutic management was at the discretion of the treating physician. At the end of the first year, the proportion of patients taking insulin + OAD increased (baseline: 24%; 1-year: 30.7%); while, those taking only OADs decreased (baseline: 74.4%; 1-year: 67.3%). Biguanides and sulfonylureas were the most commonly used OAD classes, the highest increase in use was seen for DPP4 inhibitors (baseline: 48.9%; 1-year: 58.7%). Overall, at 1-year, glycemic parameters improved significantly (p≤0.001); HbA1c improved more in the insulin versus insulin naïve subgroup (p<0.0001) (Table); but no statistical difference was noted in those who received >3 versus ≤3 OADs. All glycemic parameters improved in those receiving basal or premix insulins. Overall, 1-year data indicate that timely initiation of insulin may play an important role in improving glycemic parameters.
H. Thacker: None. R. Ghosh: Employee; Self; Sanofi. S. Krishnan: Employee; Self; Sanofi. A. Nair: Employee; Self; Sanofi. S. Mohanasundaram: Employee; Self; Sanofi. S. K. Menon: Employee; Self; Sanofi. V. Salvi: Employee; Self; Sanofi. D. Chodankar: Employee; Self; Sanofi. C. Trivedi: None. S. Wangnoo: None. A. H. Zargar: None. A. K. Das: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Pharma, Sanofi. N. Rais: None. S. Joshi: Advisory Panel; Self; Abbott, AstraZeneca, Biocon, Franco Indian, Glenmark, Lupin, Marico, Roche, Twinhealth, Zydus, Boehringer Ingelheim International GmbH, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk, Sanofi, Serdia Pharmaceuticals (India) Pvt. Ltd. A. Mithal: Advisory Panel; Self; Eris Lifesciences Limited, Consultant; Self; Glenmark Pharmaceuticals Limited, Lupin Pharmaceuticals, Inc., USV Private Limited, Speaker’s Bureau; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Intas Pharmaceuticals Ltd., Novo Nordisk, Sanofi. S. Kalra: Speaker’s Bureau; Self; Eli Lilly and Company, Novo Nordisk, Sanofi. A. Unnikrishnan: Advisory Panel; Self; Sanofi-Aventis, Other Relationship; Self; Novo Nordisk A/S, Speaker’s Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes. K. Kumar: Advisory Panel; Self; Sanofi-Aventis. B. Sethi: None. S. Chowdhury: None.
Sanofi
