Background: Type 2 Diabetes Mellitus (T2DM), is indicated as persistent hyperglycemia and
usually associated with hypertension and chronic kidney disease (CKD), which generates the
need for improving the therapeutical approach in treating the Diabetes. This study shows the
safety and efficacy of oral versus systemic antidiabetic treatments in T2DM patients with these
comorbidities.
Methods: A prospective and retrospective observational study at Mallige Hospital, Bengaluru,
enrolled 301 T2DM patients (177 males, 124 females, aged >30 years). Patients were organized
based on therapy (oral, systemic, combination) and comorbidities, the results were comprising
side effects, and drug interactions. Data were analyzed using SPSS.
Results: Combination therapy significantly improved blood glucose (p<0.05) compared to
monotherapy, particularly in patients with hypertension (42.8%) and CKD (26.9%). Systemic
therapies had more side effect rates (47.5%) than oral therapies (21.9%), with hypoglycemia
predominant. Patients with severe kidney disease were few (n=18), suggesting other factors
influencing the results. Metformin and SGLT2 inhibitors were effective for eGFR ?30
mL/min/1.73 m², while insulin was preferred for severe cases.
Conclusion: Combination therapy improves the glycemic control in T2DM with hypertension
and CKD but increases the side effect risks, notably hypoglycemia. Oral therapies, involving
metformin and SGLT2 inhibitors, are safer for stable patients, while systemic therapies arenecessary for severe hyperglycemia. Personalized treatment, accounting for drug interactions
and comorbidity profiles, is critical. Future studies should assess long-term outcomes and
newer agents like GLP-1 receptor agonists.
Keywords: Type 2 Diabetes Mellitus, Antidiabetic Therapy, Hypertension, Chronic
Kidney Disease, Glycemic Control, Drug Interactions
Publication date: 2026/10/01
https://www.ijbpas.com/pdf/2026/October/MS_IJBPAS_2026_10529.pdf
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doi.org/10.31032/IJBPAS/2026/15.10.10529
