Role of vildagliptin and its combination in type 2 diabetes mellitus management: a knowledge, attitude, and practice survey among Indian healthcare professionals

Background: Type 2 diabetes mellitus (T2DM) is a prevalent condition, with a significant burden in India, affecting approximately 74.2 million individuals. Vildagliptin, a selective dipeptidyl peptidase 4 (DPP-4) inhibitor, is approved globally for monotherapy and combination therapy. Recently, it became available as a generic product, which increased its accessibility to patients. This study aimed to assess the knowledge, attitude, and practice (KAP) regarding vildagliptin and its combination in T2DM management. Methods: A pan-India cross-sectional KAP survey was conducted from February 2022 to March 2023. The survey utilized a specially designed questionnaire focusing on various aspects of vildagliptin treatment. A total of 1,440 healthcare professionals (HCPs) with recognized qualifications and experience in diabetes management participated. Descriptive statistics were employed for data analysis. Results: HCPs reported initiating Vildagliptin monotherapy at an HbA1c 6.5-7.5%, while combination therapy with vildagliptin and metformin at HbA1c 7-8%. Vildagliptin was primarily preferred as an add-on to metformin. Inadequate HbA1c control with existing therapy emerged as the primary trigger for switching to vildagliptin and metformin combination. Treatment-naïve T2DM patients with HbA1c 1.5% above target and those uncontrolled on metformin monotherapy or dual therapy were reported to benefit most from combination therapy. Combination therapy was reported to result in a glycemic reduction of 1.0-1.5%. HCPs perceived vildagliptin better than other DPP4 inhibitors due to its efficacy in reducing HbA1c and a lower risk of hypoglycemia. Conclusions: The KAP survey highlights the value Indian HCPs place on the effectiveness and tolerability of vildagliptin and their attitudes and practices in its use, highlighting its clinical utility in routine practice.