# Expert Consensus Statement on Simplified Glycemic Care in Patients With Type 2 Diabetes Mellitus

## TL;DR

This paper provides expert recommendations for simplified diabetes care in India, focusing on better treatment adherence and outcomes.

## Contribution

The paper introduces a patient-centered, evidence-based approach to streamline T2D management in the Indian context.

## Key findings

- Early use of SGLT-2 and DPP-4 inhibitors is recommended for improved glycemic control.
- Fixed-dose combinations are emphasized to enhance adherence and reduce costs.
- Lifestyle interventions and comorbidity management are highlighted as essential components of care.

## Abstract

The growing burden of type 2 diabetes mellitus (T2D) in India, characterized by rising prevalence, complex treatment regimens, and substantial economic and psychological impact, necessitates a simplified, patient-centered approach to glycemic management. This expert consensus document presents evidence-based recommendations for streamlined glycemic care focused on enhancing treatment adherence, minimizing pill burden, and improving clinical outcomes. An expert panel of endocrinologists and diabetologists convened across eight advisory board meetings to review current evidence and generate practical strategies. Emphasis was placed on the early use of combination therapies, particularly sodium-glucose cotransporter-2 (SGLT-2) inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors, with or without metformin, tailored to individual patient profiles. The consensus underscores the importance of fixed-dose combinations (FDCs) to improve adherence and cost-effectiveness. In addition to pharmacologic strategies, lifestyle interventions, including medical nutrition therapy, physical activity, and sleep hygiene, are advocated. Special considerations are provided for managing T2D with comorbid conditions such as cardiovascular disease, chronic kidney disease, hypertension, obesity, and dyslipidemia, emphasizing the pleiotropic benefits of SGLT-2 inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. The recommendations also address barriers in the Indian healthcare landscape, including limited access to care and treatment inertia. This consensus aims to support clinicians, researchers, and policymakers in implementing an integrative, simplified care model that addresses the multifaceted challenges of T2D management in India. By adopting these recommendations, healthcare providers can enhance patient outcomes, reduce complications, and alleviate the socioeconomic burden of T2D.