ADA 2025: 8-PUB - Role of ADA Guidelines with the Indian Twist for Mitigating ASCVD Risk in Type 2 Diabetes

Introduction:

Globally, 75% of individuals with type 2 diabetes mellitus (T2DM) die from atherosclerotic cardiovascular disease (ASCVD). ADA guidelines suggests SGLT2 inhibitors for patients with high cardiovascular risk, and combination therapies for better glycemic control. This study aimed to assess ASCVD risk in Indian T2DM patients and evaluate the effect of ADA guideline-directed therapy using fixed-dose combinations (FDCs) in India.

Methods:

• Population: 50 Indian T2DM individuals ± hypertension/ dyslipidemia, aged 40–70 years, on antidiabetic treatment 
• Tool: ASCVD risk estimated using ASCVD Risk Estimator Plus
• Intervention: Initiation of FDCs (SGLT2i, DPP-4i, metformin) along other agents for T2DM individuals with low and high risk for ASCVD
• Time-points: ASCVD risk at  Day 90 was compared with that at Day 0

Results:

1. The ASCVD risk was 12.39 ± 11.41%, at Day 0, and 10.56 ± 9.74% at Day 90. HbA1c level was 9.38 ± 1.5% at Day 0 and 7.2 ± 0.7% at Day 90. 
2. BMI was 29.3 ± 4.98 at Day 0, and 28.45 ± 4.74 at Day 90. 
3. Additional cardio-metabolic improvements included:
   1. Total cholesterol reduced by 24 ± 1.2 mg/dL
   2. Triglycerides decreased by 54 ± 35.2 mg/dL
   3. LDL cholesterol dropped by 12 ± 2.5 mg/dL
   4. Systolic blood pressure reduced by 13.92 ± 6.7 mmHg
   5. Diastolic blood pressure decreased by 4.5 ± 4.0 mmHg

Conclusion:

In Indian patients with T2DM, ADA-guided therapy using fixed-dose combinations (SGLT2i, DPP-4i, metformin) alongside hypertension and dyslipidemia treatment are useful for reducing ASCVD risk.

ADA 2025, 20-23 June, Chicago