Author(s): Prabhudatta Mohapatra, Durga Madhab Kar, Karmajeet Rath, Abhisek Pal


DOI: 10.52711/0974-360X.2024.00426   

Address: Prabhudatta Mohapatra1*, Durga Madhab Kar1, Karmajeet Rath2, Abhisek Pal1
1School of Pharmaceutical Sciences, Siksha ‘O’ Anusandhan ( Deemed to be ) University, Bhubaneswar, Odisha, India.
2Institute of Medical Science and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar, Odisha, India.
*Corresponding Author

Published In:   Volume - 17,      Issue - 6,     Year - 2024

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.

Cite this article:
Prabhudatta Mohapatra, Durga Madhab Kar, Karmajeet Rath, Abhisek Pal. Clinical Management of Type II DM in patients Showing Progressive Increase in the Creatinine Level – A Cross-sectional Study. Research Journal of Pharmacy and Technology. 2024; 17(6):2719-4. doi: 10.52711/0974-360X.2024.00426

Prabhudatta Mohapatra, Durga Madhab Kar, Karmajeet Rath, Abhisek Pal. Clinical Management of Type II DM in patients Showing Progressive Increase in the Creatinine Level – A Cross-sectional Study. Research Journal of Pharmacy and Technology. 2024; 17(6):2719-4. doi: 10.52711/0974-360X.2024.00426   Available on:

1.    Afreen Arshad Choudhry, SG Rajeshwari, Arpitha Gururaja, Krishnananda Prabhu, N Ravishankar, Retrospective correlation of fasting glucose and glycated hemoglobin with serum electrolytes, urea and creatinine in diabetic patients, Asian Pacific Journal of Tropical Disease. 2014; 4, (1): S385-S388, ISSN 2222-1808.
2.    Kumsa Kene, Tesaka Wondimnew, Mengistu Welde, Tigist Mateos, Tesfaye Adugna, Urge Gerema, Daba Abdisa, Deriba Abera, Prevalence and determinants of Impaired Serum Creatinine and Urea among type 2 diabetic patients of jimma medical center, Jimma, Southwestern Ethiopia, 2019, Endocrine and Metabolic Science. 2021; 3: 100096, ISSN 2666-3961,
3.    Manoj Abraham M, TehShiueh Tyng, K. Rekha, Shanmugananth E, Kiruthika S. Comparison of Four Screening Methods for Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus Patients: A Cross Sectional Study. Research J. Pharm. and Tech. 2018; 11(12): 5551-5558.
4.    Hsu WC, Lin CS, Chen JF, Chang CM. The Effects of Dipeptidyl Peptidase 4 Inhibitors on Renal Function in Patients with Type 2 Diabetes Mellitus. J Clin Med. 2022; May 9; 11(9): 2653. doi: 10.3390/jcm11092653. PMID: 35566779; PMCID: PMC9101888.
5.    S. Preethikaa, M. P. Brundha. Awareness of Diabetes Mellitus among General Population. Research J. Pharm. and Tech. 2018; 11(5): 1825-1829
6.    Chadha M, Das AK, Deb P, Gangopadhyay KK, Joshi S, Kesavadev J, Kovil R, Kumar S, Misra A, Mohan V. Expert Opinion: Optimum Clinical Approach to Combination-Use of SGLT2i + DPP4i in the Indian Diabetes Setting. Diabetes Ther.  2022 ; May;13(5): 1097-1114. doi: 10.1007/s13300-022-01219-x. Epub 2022 Mar 25. PMID: 35334083; PMCID: PMC8948458.
7.    Bae JH, Park EG, Kim S, Kim SG, Hahn S, Kim NH. Comparative Renal Effects of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Cotransporter 2 Inhibitors on Individual Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis. Endocrinol Metab (Seoul). 2021; Apr; 36(2): 388-400. doi: 10.3803/EnM.2020.912. Epub 2021 Mar 31. PMID: 33789035; PMCID: PMC8090474.
8.    Abinaya. S.K, Vijey Aanandhi. M. An Improvement in Patient Compliance in Diabetes Mellitus. Research J. Pharm. and Tech. 2018; 11(2): 587-592.
9.    Wilding JP. The role of the kidneys in glucose homeostasis in type 2 diabetes: clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors. Metabolism. 2014; Oct;63(10): 1228-37. doi: 10.1016/j.metabol.2014.06.018. Epub 2014 Jul 2. PMID: 25104103.
10.    S.V. Rupashri, Gheena. S. Recent Advances in Diabetes Research. Research J. Pharm. and Tech. 2016; 9(10):1806-1808.
11.    Cai Y, Liu X, Xu G. Combination therapy with SGLT2 inhibitors for diabetic kidney disease. Biomed Pharmacother. 2020; Jul; 127: 110192. doi: 10.1016/j.biopha.2020.110192. Epub 2020 May 20. PMID: 32559844.
12.    Araki SI. Combined effect of sodium-glucose cotransporter 2 and dipeptidyl peptidase-4 inhibitors for diabetic kidney disease. J Diabetes Investig. 2020; Jan; 11(1): 22-24. doi: 10.1111/jdi.13147. Epub 2019 Oct 2. PMID: 31520446; PMCID: PMC6944829.
13.    G Sathyanarayanan, P. Shanmugasundaram, P. Geetha. A Prospective Observational Study on Microalbuminuria as Risk factor of Chronic Renal Failure in patients with Type 2 Diabetes. Research J. Pharm. and Tech. 2017; 10(9): 3085-3088.
14.    Yaribeygi H, Maleki M, Reiner Ž, Jamialahmadi T, Sahebkar A. Mechanistic View on the Effects of SGLT2 Inhibitors on Lipid Metabolism in Diabetic Milieu. J Clin Med. 2022; Nov. 4; 11(21): 6544. doi: 10.3390/jcm11216544. PMID: 36362772; PMCID: PMC9653639.
15.    Lewandowski MJ, Krenn S, Kurnikowski A, Bretschneider P, Sattler M, Schwaiger E, Antlanger M, Gauckler P, Pirklbauer M, Brunner M, Horn S, Zitt E, Kirsch B, Windpessl M, Wallner M, Aringer I, Wiesholzer M, Hecking M, Hödlmoser S. Chronic kidney disease is more prevalent among women but more men than women are under nephrological care : Analysis from six outpatient clinics in Austria 2019. Wien Klin Wochenschr. 2023; Feb; 135(3-4): 89-96. doi: 10.1007/s00508-022-02074-3. Epub 2022 Aug 31. PMID: 36044092; PMCID: PMC9938018.
16.    Suraj B, C D Tripathi, Krishna Biswas, B M Padhy, Tarun Arora. Research J. Pharm. and Tech. 2015; 8(1):  44-50.
17.    Diptendu Santra, Sangita Totade. Prescribing Trends of Antidiabetic Fixed dose combinations in a rural tertiary care teaching hospital in Central India: An Observational, cross-sectional study . Research Journal of Pharmacology and Pharmacodynamics. 2015; 7(1): 19-22.
18.    EMJ. 2016;1[2]:58-64. DOI/10.33590/emj/10312319.
19.    George L. Bakris, Mark E. Molitch; Should Restrictions Be Relaxed for Metformin Use in Chronic Kidney Disease? Yes, They Should Be Relaxed! What’s the Fuss?. Diabetes Care 1 July 2016; 39 (7): 1287–1291.
20.    Hur KY, Kim MK, Ko SH, Han M, Lee DW, Kwon HS; Committee of Clinical Practice Guidelines, Korean Diabetes Association; Committee of the Cooperative Studies, Korean Society of Nephrology. Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement. Diabetes Metab J. 2020; Feb; 44(1): 3-10. doi: 10.4093/dmj.2020.0004. PMID: 32097995; PMCID: PMC7043977.
21.    Bays H. Sodium Glucose Co-transporter Type 2 (SGLT2) Inhibitors: Targeting the Kidney to Improve Glycemic Control in Diabetes Mellitus. Diabetes Ther. 2013 Dec;4(2):195-220. doi: 10.1007/s13300-013-0042-y. Epub 2013; Oct 19: PMID: 24142577; PMCID: PMC3889318.
22.    Merry Raphael, Vijayanarayana K, GirishThunga, Karthik Rao N, Sreedharan N. Utilization Pattern of Anti-Diabetic Drugs in Type 2 Diabetes Mellitus in Tertiary Care Hospital. Research J. Pharm. and Tech. 2017; 10(7): 2063-2068.
23.    Oh TJ, Jung HS, Bae JH, Kim YG, Park KS, Cho YM, Park KS, Kim SY. Clinical characteristics of the responders to dipeptidyl peptidase-4 inhibitors in Korean subjects with type 2 diabetes. J Korean Med Sci. 2013: Jun; 28(6): 881-7. doi: 10.3346/jkms.2013.28.6.881. Epub 2013 Jun 3. PMID: 23772153; PMCID: PMC3678005.
24.    Manikandan. R, Sarumathy. S. Clinical study on assessment of lipid Profile and renal function in type 2 Diabetic patients- A Retrospective Study. Research J. Pharm. and Tech 2018; 11(4): 1624-1626.
25.    Ranadheer Chowdary P, Praveen. D, Vijey Aanandhi. M. A Prospective Study on Incidence of Dyslipidemia in Diabetes Mellitus. Research J. Pharm. and Tech. 2017; 10(2):431-433.

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