Evergreen Talk Series: Linagliptin and Dapagliflozin combination for T2DM with Cardiovascular risk or established ASCVD

Presenting the Evergreen Talk Series featuring Dr. Brij Mohan Makkar, a Senior Diabetologist and Obesity Specialist from Delhi, Dr. Sameer I. Dani, an Interventional Cardiologist from Ahmedabad, and Dr. Tukaram Jamale, a Nephrologist and Kidney Transplant Physician who serves as the Head of the Department at KEM Hospital Mumbai. They provide their insights on the use of Linagliptin, Dapagliflozin, and Metformin for diabetic patients.

Bringing viewpoints from the different specialities of Diabetology, Cardiology and Nephrology they share the clinical benefits of the Linagliptin and Dapagliflozin combination for T2DM with Cardiovascular risk or established ASCVD.

Dr Brij Mohan Makkar: When Linagliptin and Dapagliflozin are combined, Linagliptin demonstrates cardiovascular safety, hepatic safety, renal safety, no risk of hypoglycemia, and no weight gain. It acts indirectly on insulin secretion and suppresses glucagon. SGLT2 inhibitors are useful in reducing mortality in people with established atherosclerotic cardiovascular disease, heart failure, and advanced chronic kidney disease. Therefore, using this combination of molecules in people with established atherosclerotic cardiovascular disease or those at high risk is the recommended choice according to almost every guideline now.

Dr Sameer I Dani: Linagliptin and Dapagliflozin both have established evidence or a record of cardiovascular safety. Both have enough evidence for cardiorenal safety. These medicines belong to two different classes of drugs and complement each other. They have different mechanisms of action, different pathways of metabolism, and that's how they complement each other without causing drug interactions. So, the chances of drug-drug interactions are very low. Both agents have cardiovascular outcome benefits, making the combination use very logical.

Dr Tukaram Jamale: One of the important reasons that patient discontinues or decrease the dosages of the drug is cost and the pill burden. Patients at elevated ASCVD risks stand to benefit the most from these drugs individually. Therefore, a combination approach serves the purpose of making the treatment available at a substantially lower cost and reduces the number of pills to be consumed in a day.