{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:30:13Z","timestamp":1787841013014,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Introduction:<\/jats:title>\n Management of type 2 diabetes mellitus (DM) is a challenge for both physician and patient. The range of available therapeutic options includes large pool of oral antidiabetic drugs (OADs), noninsulin injectable therapies, and insulin therapy. The decision to initiate and intensify treatment depends on multiple factors. To achieve optimal glycemic control, a structured approach is required with more focus on correct treatment intensification.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n It is a longitudinal observational study conducted in a tertiary care hospital in Punjab in which out of a total of 400 patients attending out patient department, 286 were finally enrolled in the study. Patients already taking two OADs and still having uncontrolled Type 2 DM with HbA1c >7% were included in the study. They were followed up for next 3 months from the time of enrolment, to study the effects of the intensified drug (3\n rd<\/jats:sup>\n ADA) and compare the clinical outcome of different drugs. The unpaired\n t<\/jats:italic>\n -test and analysis of variance was used for statistical analysis.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Out of 286 patients, 155 (54.1%) HbA1c were significantly improved after adding SGLT-2 inhibitor who were previously on Metformin and DPP-4 inhibitor (mean HbA1c 9.29 \u00b1 1.84 at baseline, reduced to 8.59 \u00b1 1.74 at 12 weeks;\n P<\/jats:italic>\n = 0.000646). In 24 patients taking sulfonylureas and metformin, the addition of SGLT-2 inhibitor helped in improving HbA1c (mean HbA1c 8.99 \u00b1 1.56 at baseline, reduced to 7.91 \u00b1 1.55 at 12 weeks;\n P<\/jats:italic>\n = 0.0207).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Type 2 DM patients reported with greater percentage reduction in HbA1c after intensification with SGLT-2 inhibitors as compared with other drugs.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_1906_24","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T21:00:09Z","timestamp":1759006809000},"page":"3652-3656","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcome of treatment intensification in type 2 diabetes mellitus patients with suboptimal glycemic control on two oral antidiabetic agents"],"prefix":"10.4103","volume":"14","author":[{"given":"Deepika","family":"Garg","sequence":"first","affiliation":[{"name":"MBBS Student, Adesh University, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Singla","sequence":"additional","affiliation":[{"name":"Professor, Department of Pharmacology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakendra","family":"Singh","sequence":"additional","affiliation":[{"name":"Professsor and Head, Department of Medicine, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gesu","family":"Singla","sequence":"additional","affiliation":[{"name":"Professsor and Head, Department of Biochemistry, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish K.","family":"Gupta","sequence":"additional","affiliation":[{"name":"District Nodal Officer, RMO, Zila Parishad, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"R1-20251009","doi-asserted-by":"crossref","first-page":"107","DOI":"10.2991\/jegh.k.191028.001","article-title":"Epidemiology of type 2 diabetes-global burden of disease and forecasted trends","volume":"10","author":"Khan","year":"2020","journal-title":"J Epidemiol Glob Health"},{"key":"R2-20251009","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1001\/jama.2016.9400","article-title":"Comparison of clinical outcomes and adverse events associated with glucose-lowering drugs in patients with type 2 diabetes: A meta-analysis","volume":"316","author":"Palmer","year":"2016","journal-title":"JAMA"},{"key":"R3-20251009","doi-asserted-by":"crossref","first-page":"e001830","DOI":"10.1136\/bmjdrc-2020-001830","article-title":"Real-world clinical outcomes following treatment intensification with GLP-1 RA, OADs or insulin in patients with type 2 diabetes on two oral agents (PATHWAY 2-OADs)","volume":"8","author":"Desouza","year":"2020","journal-title":"BMJ Open Diabetes Res Care"},{"key":"R4-20251009","doi-asserted-by":"crossref","first-page":"5746","DOI":"10.1038\/s41598-020-62646-z","article-title":"Clinical outcomes of basal insulin and oral antidiabetic agents as an add-on to dual therapy in patients with type 2 diabetes mellitus","volume":"10","author":"Cheng","year":"2020","journal-title":"Sci Rep"},{"key":"R5-20251009","doi-asserted-by":"crossref","first-page":"926633","DOI":"10.3389\/fendo.2022.926633","article-title":"Comparison of empagliflozin and vildagliptin for efficacy and safety in type 2 diabetes mellitus in the Pakistani population","volume":"13","author":"Khan","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"R6-20251009","doi-asserted-by":"crossref","first-page":"e077097","DOI":"10.1136\/bmj-2023-077097","article-title":"Comparative effectiveness of second line oral antidiabetic treatments among people with type 2 diabetes mellitus: Emulation of a target trial using routinely collected health data","volume":"385","author":"Bidulka","year":"2024","journal-title":"BMJ"},{"key":"R7-20251009","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12933-020-0990-2","article-title":"Favorable pleiotropic effects of sodium glucose cotransporter 2 inhibitors: Head-to-head comparisons with dipeptidyl peptidase-4 inhibitors in type 2 diabetes patients","volume":"19","author":"Shao","year":"2020","journal-title":"Cardiovasc Diabetol"},{"key":"R8-20251009","doi-asserted-by":"crossref","first-page":"e084526","DOI":"10.1136\/bmjopen-2024-084526","article-title":"Trends in antidiabetes medication use among hospitalised patients with type 2 diabetes: A retrospective single-centre cohort study","volume":"14","author":"Meier","year":"2024","journal-title":"BMJ Open"},{"key":"R9-20251009","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1124\/pharmrev.120.000160","article-title":"New aspects of diabetes research and therapeutic development","volume":"73","author":"Satin","year":"2021","journal-title":"Pharmacol Rev"},{"key":"R10-20251009","doi-asserted-by":"crossref","first-page":"e003302","DOI":"10.1136\/bmjdrc-2022-003302","article-title":"Effect of dapagliflozin on 24-hour glycemic variables in Japanese patients with type 2 diabetes mellitus receiving basal insulin supported oral therapy (DBOT): A multicenter, randomized, open-label, parallel-group study","volume":"11","author":"Kudo","year":"2023","journal-title":"BMJ Open Diabetes Res Care"},{"key":"R11-20251009","doi-asserted-by":"crossref","first-page":"110872","DOI":"10.1016\/j.diabres.2023.110872","article-title":"Comparison of therapeutic efficacy and safety of sitagliptin, dapagliflozin, or lobeglitazone adjunct therapy in patients with type 2 diabetes mellitus inadequately controlled on sulfonylurea and metformin: Third agent study","volume":"203","author":"Hong","year":"2023","journal-title":"Diabetes Res Clin Pract"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1906_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:40:06Z","timestamp":1787838006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1906_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":11,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_1906_24","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2024-11-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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