Background: Poor compliance is reported in hospitalised patients with T2D and COVID-19 who are discharged on Basal Bolus therapy (BBT). Hence, it is mandatory to explore novel therapeutic approaches.
Methods: A single-centred retrospective study aimed to evaluate the safety and efficacy of once daily IDegAsp plus Empagliflozin-Linagliptin FDC ± Metformin in T2DM patients who were non-compliant to BBT after being discharged from hospital post dexamethasone therapy.
Results: A retrospective chart analysis performed between 01 June 2020 and 31st December 2020 yielded a record of 67 patients (33 Female and 34 Male) meeting the eligibility criterion. Mean age of patients is 59.63 ± 9.89 years. Of the 67 patients, 59 (88.05%) were non-compliant with 3 bolus doses, 43 (64.18%) with 2 bolus doses and 21 (31.34%) with one bolus dose. The compliance was highest with once daily basal insulin in 64 (94.02%) of patients. It was further observed that the basal dose was sub-optimally up titrated to achieve fasting plasma glucose target and hence 100% failed to achieve their glycemic goals 14 days post discharge. The patients non-compliant with BBT regime and failing to achieve glycemic target post discharge, were switched to once daily IDegAsp along with Empa-Lina 25/5 FDC ± 1 gram of metformin. At the end of 13 weeks, the HbA1c reduced from 10.67±2.1% to 6.85±0.54% (p<0.001) with FPG and PPG both declining from 212.72±52.01 to 118.68±15.54 mg/dL (p<0.001) and 318.22±108.47 to 154.72±27.05 mg/dL (p<0.001) respectively. The initial co-formulation dose requirement was 37.81±7.42 units which subsequently reduced to 17 ± 7.29 units, (p<0.001).
Conclusion: Switching to once daily IDegAsp and Empa-Lina 25/5 FDC ± Metformin was an efficacious and safe alternative to Basal Bolus regimen post discharge for COVID-19 pneumonitis in T2DM patients treated with Dexamethasone during in-patient stay.
S. Bhattacharyya: None.
