Fluid, electrolyte, and energy (FEE) management plays a crucial role in the recovery of patients with type 2 diabetes mellitus (T2DM) and prediabetes, especially during acute non-diarrheal illnesses. However, current diabetes management guidelines often lack specific recommendations on how to address the unique FEE needs of these patients, leading to potential gaps in managing dehydration and energy deficits. In this article, we aimed to develop practical consensus recommendations on the role of FEE management in persons with diabetes (PWDs). Modified Delphi consensus methodology was utilized to reach a consensus. A scientific committee comprising 11 experts from India formed the panel. Relevant clinical questions within four major domains were formulated for presentation and discussion: (i) burden of FEE deficits in PWDs; (ii) assessment of FEE deficits in PWDs; (iii) role of FEE management in the recovery of T2DM; and (iv) importance of sustained energy concepts in meeting the energy requirements of T2DM. The consensus level was classified as “Yes” (when ≥ 70
Introduction: The use of sodium-glucose cotransporter 2 inhibitors with metformin has become one of the preferred therapies for the management of Type 2 diabetes mellitus (T2DM). In this study, we assessed prescribing patterns in T2DM patients who were initiated dapagliflozin and metformin (Dapa-Met) as initial choice fixed dose combination (FDC). We assessed the indications for choosing Dapa-Met FDC and changes in cardiometabolic parameters. Methods: In this retrospective analysis, we included T2DM patients with hemoglobin A 1 C (HbA 1 C) >7% who were initiated with Dapa-Met FDC as initial treatment. Data HbA 1 C, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), weight, systolic blood pressure (BP), and diastolic BP were recorded after 6 months of Dapa-Met FDC. Results: In total, data from 485 T2DM patients (mean age: 59.7 ± 9.8 years) were included. The mean duration of diabetes was 6.9 ± 4.7 years. For Dapa-Met FDC, 10 mg and 500 mg were the most preferred strengths. Nearly, 78% of patients required additional antidiabetic drug. Sulphonylureas (50.7%) and dipeptidyl peptidase 4-inhibitors (36.7%) were the most common co-prescribed drugs. Besides glycemia control, Dapa-Met FDC was preferred for weight loss (77.1%) and reducing cardiovascular events and related hospitalizations (46.8%). After 6 months, changes in HbA 1 C (D - 2.19%, P < 0.0001), FPG (D - 21.4 mg/dL, P < 0.0001), and PPG (D - 37.1 mg/dL, P < 0.0001) were significant. Hypoglycemic events (16.7%) and genitourinary infections (8.9%) were the common adverse events. Conclusion: Dapa-Met (10/500 mg) as FDC is effective and safe in Indian patients with T2DM when used as an initial choice treatment for T2DM. Additional antidiabetic therapies may be necessary to achieve glycemic targets.
