Therapy patterns were examined across various subgroups during the second year of LANDMARC, a 3-year prospective observational study (CTRI/2017/05/008452) that included participants with T2D on ≥2 antihyperglycemic medications. Of 6234 evaluable participants (mean baseline values - age: 52.1 years, T2D duration: 8.59 years and A1C: 8.05%) , 5318 completed 2-year follow-up visit. Therapeutic management was at the discretion of the treating physician. At the end of the second year, the proportion of participants taking insulin + OAD increased (baseline: 24.0%; 2-years: 33.3%) ; while those taking only OADs decreased (baseline: 74.4%; 2-years: 64.8%) . Among injectable glucose-lowering drugs, there was an increase in basal, prandial and premix insulin. Biguanides and sulfonylureas were the most commonly used OAD classes, the highest increase in OAD addition was seen for DPP4 inhibitors (baseline: 3049/6234, 48.9%; 2-years: 3526/5763, 61.2%) followed by SGLT2 inhibitors (baseline: 654/6234, 10.5%; 2-years: 1227/5763, 21.3%) . Overall, glycemic parameters improved in insulin vs. insulin naïve subgroup (p<0.0001) and in ≤3 OAD vs. >3 OAD subgroup. No difference in change of glycemic parameters was noted in those on basal vs. premix insulin (Table) . Overall, 2-year data indicate that timely initiation of insulin may play an important role in improving glycemic parameters.
H. Thacker: None. A.K. Das: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Diagnostics, Sanofi. Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Lupin Pharmaceuticals, Inc., USV Private Limited. S. Joshi: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Eli Lilly and Company, Novo Nordisk, Roche Diabetes Care. Consultant; Biocon, Glenmark Pharmaceuticals, Sanofi, USV Private Limited. A. Mithal: Advisory Panel; Eris Lifesciences Ltd. Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Novartis AG, Novo Nordisk, Sanofi. S. Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. A. Unnikrishnan: Advisory Panel; Intas Pharmaceuticals Ltd. Speaker's Bureau; Abbott, AstraZeneca, Boehringer-Ingelheim, Sanofi. Other Relationship; Novo Nordisk, Serdia Pharmaceuticals (India) Pvt. Ltd., Torrent Pharmaceuticals Ltd. K. Kumar: None. B. Sethi: None. S. Chowdhury: None. A. Nair: None. S. Mohanasundaram: Employee; Sanofi. V. Salvi: Employee; Sanofi. D. Chodankar: Employee; Sanofi. C. Trivedi: None. S. Wangnoo: None. A.H. Zargar: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Intas Pharmaceuticals Ltd., Janssen Pharmaceuticals, Inc., Lupin Pharmaceuticals, Inc., Novo Nordisk, USV Private Limited. N. Rais: None.