Therapy-Driven Trajectories of Complications in Type 2 Diabetes Mellitus: A Comparative Observational Study of Standalone and Integrated Pharmacotherapy in a Tertiary Care Teaching Hospital

Background Type 2 Diabetes Mellitus (T2DM) is a progressive metabolic disorder characterized by chronic hyperglycemia, often associated with long-term microvascular and macrovascular complications. Understanding the pattern of complications among patients receiving different therapeutic modalities—standalone versus integrated therapy—can provide insights for optimizing treatment strategies. Methods A prospective observational study was conducted from September 2024 to February 2025 at the Department of General Medicine, Government General Hospital, Guntur. A total of 177 patients with T2DM (duration >2 years) were divided into four therapy groups: standalone oral therapy (n = 34), Insulin therapy (n = 14), Integrated oral therapy (n = 116), and Oral + Insulin combination therapy (n = 13). Data were collected using a validated questionnaire, entered into Microsoft Excel, and analyzed using the Microsoft Excel Toolkit. Descriptive and inferential statistics were used. Results Integrated therapy was the most common treatment (65.5%). Vision-related complications were highest in the standalone (42.4%) compared to integrated therapy groups (27.6%). A significant association was found between therapy type and complications (χ² = 24.3, p < 0.001). A longer diabetes duration was associated with an increased number of complications, while logistic regression analysis indicated that integrated therapy reduced the odds of multiple complications (p = 0.027). Conclusion Integrated therapy was associated with reduced progression and clustering of diabetes-related complications. Early initiation of combination therapy, regular screening, and patient education can help prevent chronic sequelae of T2DM.