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Issue 1

PREFACE Dear Doctor, Several pa2ents with the progression of diabetes require a combina2on of two or three drugs to achieve desired diabetes control. Glimepiride + MeAormin + Pioglitazone is a combina2on that is effec2ve and safe in suitable diabetes pa2ents. Pioglitazone, which has proven efficacy in diabetes pa2ents, especially Indians, as there is low insulin sensi2vity in diabetes, was withdrawn due to ill-informed safety concerns. Although the withdrawal was revoked, several pa2ents and doctors are concerned alike. We collected valuable opinions of key opinion leaders in diabetes management from across India on pioglitazone as well as triple combina2on and to iden2fy suitable pa2ents for its use. Therefore op2mally u2lizing the triple drug combina2on in Indian diabetes pa2ents. We asked the following ques2on to key opinion leaders: How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? We are glad to share with you the answers. We are sure that insights shared by the KOLs will go a long way in diabetes care in Indian pa2ents. Happy reading!

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Aditya Rattan, MBBS, MD (Med) Panchkula, Haryana. This is a perfect combination and provides the synergetic action of all three drugs. It provides the following benefits: 1. Reduce the pill burden of patients. 2. Reduce glucose levels very fast. 3. Reduce the cost burden. 4. Has good patient compliance. I use this combination in diabetes patients who are not controlled on monotherapy or dual therapy or having high glucose levels at the first visit.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Saurav Dey, MBBS, PGCDM, Consultant Physician, Baidyabati I often prescribe this triple-drug combination in my diabetes practice. I consider each component of this combination as essential pillars in the treatment of type 2 diabetes mellitus. Glimepiride has proven cardiovascular safety. Metformin is a well-proven agent for macrovascular protection, and Pioglitazone also has proven efficacy for stroke prevention. Three agents together target different components of \"Ominous Octet\" with sound HbA1c reduction. So in India, where compliance is an issue, I consider this combination one of the best for its safety, efficacy, affordability and acceptability in diabetes management. I prescribe it to all patients having HbA1c less than 10, with uncontrolled glucose levels, with no contraindications such as osteoporosis, macular edema, estimated glomerular filtration rate <45, heart failure and bladder cancer in the family.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Anil Vij, MBBS, MD (Medicine), Consultant Physician, New Delhi This is a combination of 3 anti-diabetic medicines. They work by different mechanisms of actions to provide better control of blood sugar when single or dual therapy is not effective. Glimepiride works by increasing the amount of Insulin released by the pancreas in order to lower blood sugar. Metformin work by lowering glucose production in the liver, delaying glucose absorption from the intestine, and increasing its sensitivity to Insulin. Pioglitazone further increases insulin sensitivity.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Sangita Ghanate, MBBS, MD (Medicine), Consulting physician, Panvel, Mumbai I often use the combination, especially in patients with metabolic syndrome and PCOS. Pioglitazone is the only drug that reverses the pathophysiology in diabetes as it increases insulin sensitivity at the cellular level. Along with being an insulin secretagogue, it reduces dose requirements up to 25 to 30%. If contraindications like heart failure and water retention are taken care of, it is a wonder drug, and in Indian patients, it is effective at very low doses. I recommend a triple combination with Pioglitazone.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Vinood Methil, MBBS, DIP. Diabetes, Consultant Diabetologist, Navi Mumbai I often use this triple-drug combination in my clinical practice. The three molecules address the two critical pathophysiological defects in Type 2 diabetes mellitus, i.e., beta-cell failure and Insulin resistance and, therefore, control the blood sugars in most of our patients. Also, the combination is very economical and, therefore, affordable to our patients, and if used diligently in the right patient in the right dose, it is very safe.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Kamal Saroj, MBBS, MD (Medicine), Consultant Physician, Thane Triple combination therapy helps to achieve the recommended goals in the management of diabetes. A fixed-dose formulation of Glimepiride + Pioglitazone + Metformin may provide advantages in glycemic control and other cardiovascular risk factors frequently associated with diabetes. It offers a useful option for managing patients with type 2 diabetes when monotherapy fails in the achievement of the recommended standards of care.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Souvik Paul, MBBS, FCCS, MD, Diabetologist, Howrah I often use this combination when patients are not controlled with two drugs. I prefer Pioglitazone when I have to add a drug to Metformin + Glimepiride treatment unless indicated otherwise. I use this triple combination because it is more effective than Voglibose in HbA1c lowering. It effectively addresses the “ominous octet” of diabetes mellitus pathophysiology rather than Voglibose. It is also the most available triple-drug combination in the market.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Agnibha Maity, MBBS, MD, Consultant Physician, Howrah I often use this triple combination because of the following reasons: • Drugs in the combination work by a different mechanism to provide better control of blood sugar in comparison to single or two-drug therapy • Glimepiride is a sulfonylurea that works by increasing the amount of Insulin released by the pancreas, which subsequently lowers blood sugar. • Metformin is a biguanide. It works by lowering glucose production in the liver, delaying glucose absorption from the intestine, and increasing its sensitivity to Insulin. • Pioglitazone is a thiazolidinedione that further increases insulin sensitivity. • In comparison to Glimepiride + Metformin + Voglibose combination, Glimepiride + Metformin + Pioglitazone causes less gastrointestinal irritation and is generally well tolerated when taken with food. Continued…

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? …Continued • The rationale for using this combination are: A. The drugs in the combination act by different mechanisms B. Pharmacokinetics are not widely different C. The combination has no super-additive toxicity to ingredients D. Better compliance E. Cost-effective The combination is contraindicated in case of congestive heart failure, kidney problem, liver problem, pregnancy and breastfeeding. On long term use, it may cause vitamin B12 deficiency as Metformin interferes with vitB12 absorption in the stomach. The combination may cause hypoglycemia. Thus, educating the patients about the signs and symptoms of hypoglycemia and its management is necessary.



How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Amit Bedi, MBBS, DIP. Diabetes & DIP. General Medicine, Diabetologist, Barasant & Barrackpore I use the triple-drug therapy of Glimepiride, Metformin and Pioglitazone very often. We are Indians, and our genetic makeup is such that we are naturally resistant to insulin activity. Pioglitazone works wonders in these patients. Sulphonylureas (Glimepiride) and Metformin combinations are as such low cost yet effective medicines for diabetes treatment. Such combinations have been used in our country for decades. Pioglitazone added to this combination increases the efficacy, has additive effects, increases insulin sensitivity, has good safety and is cost-effective. Except for a few patients complaining pedal edema or weight gain. So far, I have not encountered any other major side-effects using 15 mg Pioglitazone, which is present in the triple-drug combination. Most of my patients achieve diabetes control with this triple- drug combination when used as 1st line or 2nd line treatment.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Samiran Samui, MBBS, MD (Internal Medicine), Consultant Physician, Arambagh I use the triple combination very often (in around 30 to 40% cases). I use the combination in the following conditions: • In pa2ents with uncontrolled diabetes who are not willing to take Insulin. • In diabetes not controlled with two oral an2-diabe2c drugs and lifestyle modifica2ons. • In cases of lower economic groups who cannot afford modern Insulins or other expensive drugs. • In some cases, to reduce the pill burden, the combina2on is preferred. • In some pa2ents who take only two main meals, and a considerable amount of food is taken in between 2 meals. Of course, there are no definite contraindica2ons; thus, this combina2on is preferred.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Pratul Chatterjee, MBBS, DTM&H, Consultant, Kolkata In newly diagnosed type 2 diabetes mellitus, only Metformin is used with strict diet control and physical activity. However, in some patients, the desired result is not achieved. Glimepiride, in combination with Metformin, gives a better result than Metformin alone. However, in patients with uncontrolled blood sugar levels, a combination of Metformin, Glimepiride and Pioglitazone gives desired glycaemic control as Pioglitazone improves insulin sensitivity. It is the right combination and is often used. Dr. Venkat Reddy Palvai, MBBS, MD, Consultant Physician, Nalgonda I use the combination in patients not controlled on two drugs.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Rohit Sharma, MBBS, DNB (Medicine), Consultant Physician, Delhi Usually, a combination of Glimepiride + Metformin is enough in most patients with or without Dipeptidyl peptidase-4 (DPP4) Inhibitors. However, in refractory cases, Pioglitazone's addition gives wonderful results in controlling post-prandial excursions and regulating fasting sugar levels. So in recent times, we have again switched our attention to this old drug, Pioglitazone. Dr. VN Garg, MBBS. MD, Consultant physician, Delhi The combination provides triple action for glycaemic control. I use it in patients with uncontrolled diabetes despite other triple-drug combinations.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Salim Nizami, MBBS, MD, Consultant Physician, Delhi This combination works by different modes of actions to better control HbA1c, fasting blood glucose, and post-prandial blood glucose when single and two drug therapies are not sufficient. Glimepiride acts by increasing the amount of Insulin released by the pancreas to lower blood glucose. Metformin acts by lowering glucose production in the liver. Pioglitazone further increases insulin sensitivity. Dr. Mohit Lathar, MBBS, MD (Medicine), Medical Director, Gurugram I use the triple combination in young non-cardiac diabetic patients who are obese, and females in pre-menopause stage.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. K Srinivas, MBBS, GRAD. DIP. Diabetes, Consultant Diabetologist, Chennai I use this combination very frequently. I use this combination before using another type of drug or increasing the dose of the currently used drugs. I use the combination in patients with not so good control of diabetes with Glimepiride and Metformin as they do very well with this combination. The combination is useful in many of the patients who are apprehensive about taking Insulin due to poor glycemic control and ideal candidates for this triple-drug combination. Dr. Sanjay Gogia, MBBS, MD (Medicine), Consultant Physician, Delhi I use the combination in patients who cannot achieve the HbA1c target on two drugs and follow a poor lifestyle.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Sanjay Arora, MBBS, MD, Consultant Physician, Delhi Pioglitazone, Metformin, and Glimepiride effectively reduce blood glucose in patients with newly diagnosed Type 2 diabetes. However, their specific characteristics, such as the rapid action on blood glucose levels of Glimepiride and the favorable action on fasting and free fatty acids of Pioglitazone, should be considered while treating. Dr. Saket Kant, MBBS, DM (Endocrinology), Endocrinologist, Delhi Metformin, Glimepiride and Pioglitazone is the best combination to reduce HbA1c. I often prescribe this combination to uncontrolled diabetic patients.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Kunal Chawla, MBBS, MD, Consultant Physician, Delhi The triple-drug combination of Glimepiride, Metformin and Pioglitazone work by different mechanisms to provide better sugar control when single and dual therapy fails. This combination is safe and effective in type 2 diabetic patients. I prescribe this combination to my patients for better control. Dr. Rahul Jain, MBBS, MD Physician, Consultant Physician, Delhi Robust efficacy and safety of Glimepiride, Metformin and Pioglitazone combination provides a better choice for uncontrolled patients. Their different mechanism of actions reduces HbA1c significantly. This combination is approved for type 2 diabetic patients.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Mukesh Kumar Nagpal, MBBS, MD, Consultant Physician, Delhi The efficacy and safety of Glimepiride, metformin and pioglitazone combination is the right choice for uncontrolled patients. Triple drug combination works by a different mechanism to provide better sugar control when single and dual therapy fails. It reduces HbA1c significantly. Dr. A Sridhar Reddy, MBBS, MD, Diabetologist, Mahabubnagar This Combination helps control blood sugar levels when used together with diet and exercise in adults with type 2 diabetes mellitus. It helps in the proper utilization of Insulin, thereby lowering the blood sugar levels.



How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Pradeep Krishnaji Ghumare, MBBS, Family Physician With Special Interest in Diabetes, Mumbai I have been prescribing this combination very often. I am getting an excellent response to it. Pioglitazone acts when mono or dual therapy does not work. It reduces blood sugar levels and has good patient compliance. Dr. Rohit Shankhwar, MBBS, DNB, Consultant Physician, Mumbai I prefer this combination in type 2 diabetes mellitus patients whose sugar levels are not controlled by a single or double combination to reduce the pill burden. We also use it in patients with high post-prandial glucose levels and high HbA1c levels.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Subha Sankha Kundu, MBBS, MD, General Practitioners, Kolkata This combination is given in patients with diabetes who require a bit more control, mainly in the post-prandial part. However, it should be kept in mind that the Pioglitazone causes weight gain and fluid retention, so patients should be selected wisely, best judged by the attending physician. Dr. Mukesh Madan, MBBS, FCGP, ECFMG (USA), Family Physician, New Delhi This combination work by a different mechanism of action to provide better control of HbA1c, fasting- and post-prandial -glucose levels when single and two drug therapy is not sufficient and triple combination is required.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Vinod Kumar Chavan, MBBS, MD, Consultant Physician, Hyderabad I use this combination when duel combination drugs do not control patients' glucose levels. Dr. Mudassir Ali, MBBS, MD, Diabetologist, Hyderabad I use this combination very frequently in uncontrolled obese diabetics patients. Dr. Kishore Babu Kunta, MBBS, MD, Diabetologist, Hyderabad In patients where glucose levels are not controlled with single or dual therapy, I use this combination in day to day practice.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Nanda Kumar Yadav, MBBS, MD, Diabetologist, Sangareddy In diabetic patients whose glucose levels are above 300 mg/dL, I use this combination along with Insulin. Dr. Siddharth Singh, MBBS, DNB (Medicine), Consultant Physician, Mumbai I often use in post-meal hypoglycemia. It is also an add on therapy. It reduces pill burden as well. It is an effective combination, and I recommend it. Dr. Pankaj Kumar, MBBS, MD Physician, Consul2ng Physician, Ulhasnagar We often use this combination when a primary drug or monotherapy fails. It is the right combination with good results.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Nanda Kumar Yadav, MBBS, MD, Diabetologist, Sangareddy In diabetic patients whose glucose levels are above 300, I use this combination along with Insulin. Dr. CH Jyothsna, MBBS, MD, DNB, Consultant Physician, Warangal, Narsampet I use in uncontrolled type 2 diabetes patients with fasting blood sugar more than 360 mg/dL. Dr. DT Gaikwad, MBBS, DIP. Diabetes, Consul2ng Diabetologist, Ulhasnagar In the case of poor-compliance to 2 drug combinations, Pioglitazone works as an add on therapy with targeted values. It works mainly in thin diabetes patients and can also be prescribed with Insulin.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Ananya Mukherji, MBBS, MD (Medicine), Professor, Ghatkopar I use the combination in patients not controlled on two drugs and not willing to take Insulin. Dr. Amit Sen, MBBS, DTM&H, Physician, Beliaghata It is a useful combination, being very effective with a reduced pill burden. Dr. K Seetharamayya, MBBS, Diabetologist, Ongole I prescribe the triple combination very regularly. I prescribe in type 2 diabetes patients uncontrolled with two drugs and in high blood sugar patients.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Suprio Saha, MBBS, MD, DGM, Consultant Physician, Kolkata I often use this drug in patients who do not have any renal or hepatic impairments. Dr. PK Kundu, MBBS, MD (Medicine), Diabetologist, Kolkata I use this combination in all young and middle-aged patients with metabolic syndrome. Dr. AK Jain, MBBS, MD, Physician, Kolkata Triple drug combinations of Glimepiride metformin and Pioglitazone is excellent for Indian type 2 diabetes patients. Easy to prescribe, widely available, cost-effective and efficacious.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Arcojit Ghosh, MBBS, MD, Diabetologist, Kolkata As initiation or as second-line therapy following Metformin + Glimepiride combination. Pankaj D. Bachhao, MBBS, MD (Medicine), Consultant Physician, Thane I often use in patients with uncontrolled post-prandial blood sugar. Dr. Mahendra H Patel, MBBS, DIP. Diabetes, Consultant Diabetologist, Thane I use the combination in uncontrolled diabetes with single or two-drug therapy in lean and obese type 2 diabetes patients with Insulin resistance signs.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Sandeep Sonawane, MBBS, MD, Physician, Navi Mumbai Suitable for uncontrolled diabetes mellitus because of better efficacy, reduced pill burden, synergistic effect and cost- effectiveness. Dr. Suresh Ade, MBBS, DIP. Diabetes & Endocrinology, DIP. Neuropathy, Physician, Diabetologist & Neurologist, Nerul, Mumbai I often use the combination in diabetes patients not controlled on Metformin and Dipeptidyl-peptidase 4 (DPP4) Inhibitor Dr. KirR Samudra, MBBS, MD (Medicine), Physician & Diabetologist, Panvel, Mumbai Many of my uncontrolled type 2 DM patients, I prescribe this triple-drug combination, which certainly delays insulin initiation in them and helps to achieve target HbA1c.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Tapas Kumar Har, MBBS, DCH, MD, DNB, MD Pathology, Consulting physician, Kalimpong I often use it for resistant cases, usually in those who are suffering for more than five years. Dr. Kulbhushan Gangwani, MBBS, MD (Medicine), Consultant Physician, New Delhi The drugs in this combination act by a different mechanisms to better control blood sugar when single- or two-drug therapies are not sufficient. Dr. RK Marya, MBBS, MD (Medicine), Consultant Physician and Diabetologist, New Delhi This combination helps in controlling blood sugar levels. It is used together with diet and exercise to reduce blood sugar levels in type 2 diabetes mellitus.



How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Mary D' Cruz, MBBS, MD, DIP. Diabetes, Diabetologist, Kolkata I use it in newly diagnosed diabetes uncontrolled on monotherapy and two-drug combination therapy. Dr. S Kesavarao Babu, MBBS. DIP. Diabetes, Consultant Physician, Vijayawada I use the triple combination when patients are not under control with two drugs. Dr. Nadim Akhter Khan, MBBS, DIP. Cardiology, DIP. Diabetes (TN), Fellowship in Diabetes CMC (Vellore), Consultant Physician, Kolkata I regularly prescribe the combination in patients who tend to have a sudden spike in fasting and post-prandial glucose levels. The combination effectively reduces HbA1c, and it gives me a satisfactory and efficacious reduction in all the three mentioned parameters.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. J Naveen Reddy, MBBS, MD, General Physician, Madhira I use this combination instead of adding Insulin in patients who are not controlled with two oral anti-diabetic drugs. Dr. Emmy Grewal, MBBS, DM Endocrinology, Endocrinologist, Mohali I often use this combination, and it provides good results. I use the combination in patients having high blood glucose levels despite two oral anti-diabetic drugs. Dr. Rashmi Dhawan, MBBS, MD (Medicine), Consultant Physician, Chandigarh I use this combination quite frequently as it provides good glycaemic control and lowers HbA1c. I prescribe the combination in patients who are not controlled on monotherapy or dual therapies.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Satchidanand Payannavar, MBBS, PG DIP. Emergency Medicine, Intensivist, Rajawadi Hospital I use the combination in the majority of my patients as the combination achieves good HbA1c control. Dr. Ritesh Bansal, MBBS, MD, Consultant Diabetologist and Physician, Delhi The triple-drug combination is an excellent option to achieve target HbA1c levels in patients with poor diabetes control on single or double drugs to achieve target HbA1c. Dr. M Muralikrishna, MBBS, MD (Diabetes), Diabetologist, Vijayawada A triple-drug combination is the best when the patient is not on glycaemic control with two drugs. It is also useful when the patient is not willing to take Insulin, as this is the only option.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. Y Sadasivarao, MBBS, DIP. Diabetes, Diabetologist, Vijayawada I use this triple-drug combination in patients who fail to achieve diabetes control on single- or two-pill combination. Dr. DS Goel, MBBS, MD (Medicine), Consultant Physician, Ambala I use this combination very frequently and get good results. The combination has good patient compliance and is cost- effective. I prescribe this combination in patients having high glucose and HbA1c levels. Dr. Vijaya Sree, MBBS, MD (Medicine), Consultant Physician, Ongole My first choice in uncontrolled diabetes and post-prandial hyperglycemia.

How often do you prescribe Glimepiride + Metformin + Pioglitazone in clinical practice & In which kind of patients you prescribed this triple drug combination? Dr. SK Sharma, MBBS, MD (Medicine), Consultant Physician, Shimla I use this combination regularly and find it very useful in achieving good HbA1c control. I use the combination in patients having high HbA1c not controlled by monotherapy and dual therapy. Dr. Krishna Mohan T Kosuri, MBBS, MD, Diabetologist, Visakhapatnam We often use this combination in the following patients: 1. Patients with high glycaemic levels 2. In Insulin resistant diabetes Glimepiride and Pioglitazone have two different mechanisms of actions. Pioglitazone acts as Insulin sensitizing agent in type 2 diabetes mellitus.



Thanks the key opinion leaders for their valuable inputs and opinions on diabetes management with triple drug combination. Disclaimer: The opinions shared by the doctors in this input are their own opinions derived based on their personal clinical experience and available research publications. We suggest you to do your due diligence before implementing any recommendations mentioned in any of the doctors’ opinions. The publisher or sponsor is not responsible for inaccuracies, inconsistencies, errors or outcomes arising from this publication.