Clinical Drivers, Benefits, and Challenges of Triple Oral Therapy in Type 2 Diabetes: A Survey Based Assessment of Glimepiride, Sitagliptin, and Metformin Use
Dr. SHISHIR KUMAR MISHRA
, Dr. ANUBHAV KUMAR VERMA , Dr. A AHMAD , Dr. REETURAJ , Dr. SABA AHMAD
Triple oral therapy, Glimepiride, Sitagliptin, Metformin, Clinical inertia, HbA1c.
Background: Type 2 diabetes mellitus (T2DM) is a progressive metabolic disorder characterized by worsening glycemic control over time, often necessitating treatment intensification beyond dual oral therapy. Despite guideline recommendations, clinical inertia frequently delays escalation, exposing patients to prolonged hyperglycemia. Triple oral therapy combining metformin, sitagliptin, and glimepiride represents a practical and widely used intensification strategy, particularly in real-world settings.
Objective: This study aimed to evaluate real-world perceptions, prescribing patterns, and clinical experiences of healthcare professionals (HCPs) regarding the use of glimepiride, sitagliptin, and metformin triple oral therapy in patients with T2DM inadequately controlled on dual therapy, and to contextualize these findings within current published evidence.
Methods: A questionnaire-based observational survey was conducted among 15 HCPs managing patients with T2DM. The survey comprised 12 structured and open-ended questions addressing the prevalence of inadequate control on dual therapy, triggers for intensification, preferred third agents, dosing patterns, perceived clinical benefits, contributors to clinical inertia, and overall satisfaction. Findings were interpreted alongside data from recent randomized trials, observational studies, and systematic reviews.
Results: Most HCPs reported that a substantial proportion of patients remain uncontrolled on dual therapy, necessitating escalation. Poor glycemic control was the most common trigger for intensification. Glimepiride was the preferred third agent for two-thirds of respondents, typically prescribed at low doses (≤1 mg) alongside sitagliptin and metformin. Clinicians observed meaningful glycated hemoglobin (HbA1c) reductions (up to ~1.5%), improved postprandial control, good tolerability, and low risk of severe hypoglycemia. Insufficient evidence on specific triple combinations and safety concerns was identified as a key contributor to clinical inertia. Overall satisfaction with triple therapy was high.
Conclusion: Triple oral therapy with glimepiride, sitagliptin, and metformin is perceived by clinicians as an effective, well-tolerated, and practical option for patients with T2DM inadequately controlled on dual therapy. Timely intensification using this regimen may help overcome clinical inertia and improve glycemic outcomes, particularly in settings where injectable therapies are less feasible.
"Clinical Drivers, Benefits, and Challenges of Triple Oral Therapy in Type 2 Diabetes: A Survey Based Assessment of Glimepiride, Sitagliptin, and Metformin Use ", IJSDR - International Journal of Scientific Development and Research (www.IJSDR.org), ISSN:2455-2631, Vol.11, Issue 1, page no.b193-b198, January-2026, Available :https://ijsdr.org/papers/IJSDR2601123.pdf
Volume 11
Issue 1,
January-2026
Pages : b193-b198
Paper Reg. ID: IJSDR_307011
Published Paper Id: IJSDR2601123
Downloads: 000215
Research Area: Humanities All
Country: Mumbai, Maharashtra, India
ISSN: 2455-2631 | IMPACT FACTOR: 9.15 Calculated By Google Scholar | ESTD YEAR: 2016
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 9.15 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator
Publisher: IJSDR(IJ Publication) Janvi Wave
