Diabetes Mellitus continues to be a major non- communicable disease with global burden of 366 million at present and projected to increase to 439 to 552 million by 2030, India being the hub of diabetes. Sodium glucose transporter 2 (SGLT2) inhibitors presents a new class of anti-diabetic drugs having an insulin-independent mechanism that offers a considerable advantage of increasing urinary glucose excretion without inducing hypoglycemia and promoting weight loss due to loss of 300 to 400kcal/day, Canagliflozin being the 1st successful candidate of this group and became the first SGLT2 inhibitor to be FDA approved on March 29, 2013. In various clinical trials, it has shown promising results in controlling glycemia, causing weight loss, reducing systolic and diastolic BP and cardiovascular risk. There are some safety concerns associated with its use e.g. genital mycotic infections, increased urination, urinary tract infection and hyperkalemia, which need to be carefully addressed while using this drug.

The prevalence of asthma is rising worldwide with 10-12% adults and 15% children affected presently. It can have a considerable impact on the quality of life of both, patients and their caregivers. Fixed dose combination of Inhaled corticosteroids (ICS) like fluticasone and budesonide and long acting beta 2 agonists (LABAs) in the form of metered dose inhaler (MDI) are synergistic in action and provide effective control in asthma. Objectives: In the present study, two ICS & LABA combinations i.e. fluticasone/ formoterol and budesonide/ formoterol were compared, both administered through a metered dose inhaler (MDI) with a spacer, for achieving and maintaining asthma control, improving symptoms, pulmonary function tests and quality of life in patients of mild to moderate bronchial asthma. Methods: It was a prospective, open-label, randomized, parallel study conducted for a total duration of 12 weeks. The parameters used to compare the two MDIs at 0, 6 and 12 weeks were: a. Pulmonary function tests -FEV1, PEFR b. Asthma control scoring (according to the GINA definition of "control") c. Standardized Asthma Quality of Life Questionnaire [AQLQ(S)] d. Adverse effect profile Results: By the end of 12 weeks, asthma control was similarly achieved among the two groups except that fluticasone/ formoterol was significantly better than budesonide/ formoterol in reducing the need for rescue bronchodilator use (p= 0.000) and in improving daytime symptoms at 6 weeks (p=0.000). Fluticasone/ formoterol at 6 weeks, significantly increased the percent predicted PEFR (p= 0.007) and percent improvement in AQLQ(S) score (p=0.006) in comparison to budesonide/ formoterol. Conclusion: Fixed dose combination MDIs containing fluticasone/ formoterol and budesonide/ formoterol are effective in elevating pulmonary functions, controlling & relieving symptoms and revamping the quality of life in patients of bronchial asthma. Fluticasone/ formoterol were better in providing a more rapid and greater improvement in percent predicted PEFR, controlling daytime symptoms for a longer time and reducing the need for rescue therapy. Both the treatments were well tolerated.