Association Between Antidiabetic Drug Therapy and Biochemical Markers of Glycemic Control, Lipid Profile, and Renal Function Among Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Observational Study.

Nageswara Rao T; K. Nagaraju; Chalapathi Reddy Akumalla

doi:10.51168/2zyd2038

Authors

Dr. Nageswara Rao T Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh
K. Nagaraju Assistant Professor , Department of Biochemistry, Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad,Telangana
Chalapathi Reddy Akumalla Tutor, Department of Biochemistry, Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad,Telangana

DOI:

https://doi.org/10.51168/2zyd2038

Keywords:

Antidiabetic drugs, type 2 diabetes mellitus, glycated haemoglobin, lipid profile, renal function, sodium-glucose cotransporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors

Abstract

Background:

Type 2 diabetes mellitus requires individualized antidiabetic therapy because glycaemic status, dyslipidaemia, and renal dysfunction commonly coexist and influence treatment selection. Biochemical monitoring helps clinicians identify patients with poor metabolic control and early renal risk.

Objectives:

To assess the association between antidiabetic drug therapy and biochemical markers of glycaemic control, lipid profile, and renal function among patients with type 2 diabetes mellitus.

Methods:

This cross-sectional observational study included 100 patients with type 2 diabetes mellitus attending Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, Andhra Pradesh, India, from February 2025 to January 2026. Demographic details, duration of diabetes, body mass index, comorbidities, antidiabetic therapy, fasting blood glucose, postprandial blood glucose, HbA1c, lipid parameters, serum urea, serum creatinine, estimated glomerular filtration rate, and urine albumin-creatinine ratio were recorded. Associations were analysed across therapy groups.

Results:

The mean age was 53.2 ± 10.6 years, and males constituted 56.0%. Metformin monotherapy was used in 26.0%, metformin with sulfonylurea in 24.0%, DPP-4 inhibitor-based therapy in 18.0%, insulin-based therapy in 20.0%, and SGLT2 inhibitor-based therapy in 12.0%. Overall mean HbA1c was 8.2 ± 1.4%. Insulin-based therapy was associated with higher HbA1c, higher triglycerides, lower eGFR, and higher albuminuria, whereas SGLT2 inhibitor-based therapy showed comparatively favourable glycaemic and lipid parameters.

Conclusion:

Antidiabetic drug therapy showed significant association with glycaemic, lipid, and renal biochemical markers. Poorer profiles among insulin-treated patients reflected greater disease burden and longer diabetes duration rather than a direct drug effect.

Recommendations:

Routine integrated assessment of HbA1c, lipid profile, eGFR, and albuminuria is recommended during diabetes follow-up.

Author Biographies

Dr. Nageswara Rao T, Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh

is currently serving as an Associate Professor of Pharmacology at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, East Godavari District, Andhra Pradesh, India. He holds a doctoral degree in Medical Pharmacology from the prestigious Index Medical College and Research Institute, Madhya Pradesh. With over 16 years of teaching experience in various medical institutions, Dr. Nageswararao has made significant contributions to the field of pharmacology. His academic work includes nine research publications in reputed national and international journals, including one article indexed in PubMed. His dedication to research and education continues to enrich the academic and clinical landscape of medical pharmacology. ORCID iD: https://orcid.org/00090005-1638-6897
K. Nagaraju, Assistant Professor , Department of Biochemistry, Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad,Telangana

is an Assistant Professor in the Department of Biochemistry at Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad, Telangana, India. He is involved in undergraduate medical teaching, laboratory-based academic activities, and clinical biochemistry training. His areas of academic interest include biochemical markers in disease assessment, metabolic disorders, and laboratory medicine.
Chalapathi Reddy Akumalla, Tutor, Department of Biochemistry, Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad,Telangana

is a Tutor in the Department of Biochemistry at Neelima Institute of Medical Sciences, Ghatkesar, Hyderabad, Telangana, India. He contributes to undergraduate teaching, practical demonstrations, and departmental academic activities in biochemistry. His academic interests include clinical biochemistry, metabolic profiling, and application of biochemical investigations in patient care.

References

1. American Diabetes Association Professional Practice Committee. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2025. Diabetes Care. 2025 Jan 1;48(1 Suppl 1):S181-S206. https://doi.org/10.2337/dc25-S009

2. American Diabetes Association Professional Practice Committee. 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2025. Diabetes Care. 2025 Jan 1;48(1 Suppl 1):S128-S145. https://doi.org/10.2337/dc25-S006

3. American Diabetes Association Professional Practice Committee. 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes-2025. Diabetes Care. 2025 Jan 1;48(1 Suppl 1):S239-S251. https://doi.org/10.2337/dc25-S011

4. Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The Global Epidemiology of Diabetes and Kidney Disease. Adv Chronic Kidney Dis. 2018 Mar;25(2):121-132. https://doi.org/10.1053/j.ackd.2017.10.011

5. Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nat Clin Pract Endocrinol Metab. 2009 Mar;5(3):150-159. https://doi.org/10.1038/ncpendmet1066

6. UK Prospective Diabetes Study Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes. Lancet. 1998 Sep 12;352(9131):854-865. https://doi.org/10.1016/S0140-6736(98)07037-8

7. UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet. 1998 Sep 12;352(9131):837-853. https://doi.org/10.1016/S0140-6736(98)07019-6

8. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008 Oct 9;359(15):1577-1589. https://doi.org/10.1056/NEJMoa0806470

9. Scirica BM, Bhatt DL, Braunwald E, Steg PG, Davidson J, Hirshberg B, et al.; SAVOR-TIMI 53 Steering Committee and Investigators. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N Engl J Med. 2013 Oct 3;369(14):1317-1326. https://doi.org/10.1056/NEJMoa1307684

10. Green JB, Bethel MA, Armstrong PW, Buse JB, Engel SS, Garg J, et al.; TECOS Study Group. Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2015 Jul 16;373(3):232-242. https://doi.org/10.1056/NEJMoa1501352

11. Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al.; EMPA-REG OUTCOME Investigators. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015 Nov 26;373(22):2117-2128. https://doi.org/10.1056/NEJMoa1504720

12. Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al.; CANVAS Program Collaborative Group. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017 Aug 17;377(7):644-657. https://doi.org/10.1056/NEJMoa1611925

13. Wanner C, Inzucchi SE, Lachin JM, Fitchett D, von Eynatten M, Mattheus M, et al.; EMPA-REG OUTCOME Investigators. Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes. N Engl J Med. 2016 Jul 28;375(4):323-334. https://doi.org/10.1056/NEJMoa1515920

14. Afkarian M, Sachs MC, Kestenbaum B, Hirsch IB, Tuttle KR, Himmelfarb J, et al. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol. 2013 Feb;24(2):302-308. https://doi.org/10.1681/ASN.2012070718