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Validation of RSSDI therapeutic wheel with clinical experience of Indian physicians

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background

The Research Society for Study of Diabetes in India (RSSDI) has developed country-specific guidelines focusing on patient-centric approach for effective management of type 2 diabetes mellitus(T2DM) depending on modifiable and non-modifiable risk factors and pre-existing complications (ABCDEFG).

Methods

We conducted a multicenter, retrospective real world study (n = 780) to validate the use of RSSDI therapeutic wheel by using individually preferred guidelines and clinical expertise of Indian physicians.

Result

In elderly population (> 60 years), most commonly prescribed oral hypoglycemic agents (OHA) were DPP-4i (91.23%), metformin (74.74%), sulfonylureas (66.49%), and SGLT-2i (56.18). In patients with BMI > 30 kg/m2 (n = 133), order of preference was metformin (92.48%), DPP-4i (34.58%), and SGLT-2i (34.58%). In patients with eGFR 30–45 ml/min/1.732 (n = 32), metformin (81.25%), DPP-4i (40.63%), and SGLT-2i (40.63%) were prescribed. Analysis of prescription pattern according to baseline glycemic status (n = 380) shows most commonly prescribed OHA in patients with HbA1c > 10% (n = 144) were metformin (n = 144, 100%), sulfonylureas (n = 75, 52.08%), insulin (n = 74, 51.38%), and DPP-4i (n = 71, 50%). We observed increasing use of DPP-4i (43.33% for < 6 months to 51.69% for > 10 years), SGLT-2i (30% for < 6 months, 34.74% for > 10 years), insulin (20% for < 6 months to 46.61% for > 10 years), and AGI (6.66% for < 6 months to 12.71% for > 10 years) with increasing duration of diabetes. Most commonly prescribed drugs in T2DM with CVD were metformin (81.30%), DPP-4i (49.59%), and insulin (34.96%). In patients with limited financial status, metformin (67.70%), sulfonylureas (45.07%), and insulin (39.43%) were commonly used. The findings from prescriptions prescribed after identifying the most important factors (ABCDEFG) helped in obtaining better glycemic control among these subjects. This validated the suggestions of RSSDI therapeutic wheel.

Conclusion

Physicians can adopt RSSDI therapeutic wheel for simple patient centric and effective management of T2DM.

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Authors and Affiliations

  1. Rudraksha Institute of Medical Sciences, Ahmedabad, Gujarat, India

    Dhruvi Hasnani, Vipul Chavda & Shriji Hasnani

  2. Marwari Hospitals, Guwahati, Assam, India

    Dinesh Agrawal

  3. HOD Diabetes Wellness Care (a Unit of Shanti Wellness Care), Visiting Consultant B M Birla Heart Research Centre, Bellevue Nursing Home, Kolkata, West Bengal, India

    Bijay Patni

  4. Jothydev’s Diabetes Hospital & Research Center, Attingal, Trivandrum, Kerala, India

    Ashwin David

  5. Vibha Clinic, Nagpur, Maharashtra, India

    Sachin Gathe

  6. North Delhi Diabetes Centre Rohini, New Delhi, India

    Rajeev Chawla

  7. Jothydev’s Diabetes Research Centres, Thiruvananthapuram, Kerala, India

    Jothydev Kesavadev

  8. Sunil’s Diabetes Care & Research Center, Pvt, Ltd., Nagpur, Maharashtra, India

    Sunil Gupta

  9. Diabetes Care & Hormone Clinic, Ahmedabad, Gujarat, India

    Banshi Saboo

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  1. Dhruvi Hasnani
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Correspondence to Dhruvi Hasnani.

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Hasnani, D., Chavda, V., Agrawal, D. et al. Validation of RSSDI therapeutic wheel with clinical experience of Indian physicians. Int J Diabetes Dev Ctries 42, 451–458 (2022). https://doi.org/10.1007/s13410-021-00998-6

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  • DOI: https://doi.org/10.1007/s13410-021-00998-6

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