Comparative Effectiveness of Antidiabetic Treatments on Metabolic Control and Complications among Type 2 Diabetes Patients: A Real-World Observational Study with Public Health Implications

Background : Type 2 diabetes mellitus (T2DM) remains a major global health challenge, with rising prevalence and significant complications. This study aimed to evaluate the effectiveness of various antidiabetic treatment regimens on glycemic control, blood pressure, body mass index (BMI), and diabetic foot complications. Methods : A cross-sectional study was conducted among 150 T2DM patients (92 females, 58 males; mean age 62 ± 9.4 years) over six months. Data on fasting blood sugar (FBS), blood pressure, BMI, medication regimens, and diabetic foot complications were collected from electronic medical records. Statistical analysis was performed using SPSS version 26, with p < 0.05 considered significant. Results : The majority of patients (72%) were aged 50–69 years. Metformin-based therapies were most common (83.3%), with metformin monotherapy showing the best glycemic control (mean FBS 165.4 mg/dL). Insulin-containing regimens were associated with the highest FBS levels (224.3 mg/dL) and a 50% rate of diabetic foot complications. Patients with obesity (BMI ≥30) had significantly higher systolic blood pressure (141.3 mmHg, p < 0.01). Diabetic foot was observed in 12% of patients and was strongly associated with elevated FBS (258.3 mg/dL, p < 0.001), longer diabetes duration, insulin use, and higher BMI. Conclusion : Metformin and metformin-gliclazide regimens demonstrated superior glycemic control and lower complication rates compared to insulin-based therapies. Blood pressure and BMI were significantly correlated, emphasizing the need for integrated management of T2DM and comorbidities. These findings support personalized treatment approaches to reduce complications and improve long-term outcomes in T2DM patients.