Efficacy of SGLT2 Inhibitors as the Fifth Drug in the Management of Type 2 Diabetes Mellitus in Asian Indians not Controlled with at least 4 Oral Antidiabetic Drugs.

Aim: To evaluate the efficacy of SGLT2 inhibitors as an add-on therapy along with stricter lifestyle modification in Asian Indian type 2 diabetes mellitus (T2DM) patients with inadequate glycemic control despite receiving an optimum dose of at least 4 oral antidiabetic drugs (OADs).

Methodology: A retrospective analysis of data of 808 T2DM patients being treated with an SGLT2 inhibitor (Dapagliflozin, Empagliflozin or Canagliflozin) as an add-on drug in patients with inadequate glycemic control despite receiving optimum doses of at least any four OADs(metformin, sulphonylureas, pioglitazone, DPP4 Inhibitors, alpha-Glucosidase Inhibitors) and who preferred not to initiate insulin.

Results: The average age of the patients included was 51.

Autoimmune Hypoglycemia Relapse on Glucocorticoids, Effectively Treated with Azathioprine.

Autoimmune Hypoglycemia, though very rare in India, but can be challenging to manage. Insulin autoimmune syndrome (IAS) should be considered in any patient with hypoglycemia in the setting of unsuppressed insulin levels associated with anti-insulin or anti insulin receptor antibodies. We are reporting the clinical course of one such case of insulin autoimmune syndrome, who was initially treated with glucocorticoids.