Clinical Management of Type II DM in patients Showing Progressive Increase in the Creatinine Level – A Cross-sectional Study

Abstract

Objective: The current study focuses on the most effective selective combination of SGLT2 inhibitor and DPP4 inhibitor as first-line therapy in Type II DM with renal disease when metformin is removed from the treatment regimen, with reference to urea and creatinine levels. Methods: This is a Cross-sectional study in which diabetic kidney disease subjects are involved. They are on the follow-up of treatment in which FBS, PPBS, and HbA1C are monitored through a focus on urea and creatinine levels, whereas the lipid profile is also considered. A limited class of antidiabetic drugs is given to the patients. Result: While monitoring the gender group, males are more prone to diabetic kidney disease than females. By using fixed treatment by sulfonylureas, SGLT2 inhibitors, and DPP4 inhibitors, our expected outcomes based on the combination of SGLT2 inhibitors and DPP4 inhibitors show a significant change in glycemic index with addition to urea and creatinine levels, but there is no significant evidence of lipid profile changes. If considering the level of creatinine that didn’t show the significant change (p value of .637) from visit 1 to visit 2 but it shows significant (p value of .000) difference in visit 1 to visit 3. There is also significant change in male as well as female (p value of .000) in visit 1 to visit 3 respectively. If considering Glycated Haemoglobin (HbA1c) level of male and female, then male (p value of .000) shows significant change as well as female (p value of .011) also have significant change between visit 1 and 3. Conclusions: SGLT2 inhibitors and DPP4 inhibitors are safer drugs that are preferable to metformin in diabetic kidney disease. But monotherapy drugs may not have given the expected result. The gender-based study needs to complete the sex-specific therapy.