BACKGROUND: According to the ICMR-INDIAB study, there are 62.4 million people living with diabetes in India. Type 2 diabetes (T2DM) is a progressive disease and hampers the quality of life of the patients due to micro and macrovascular complications. There are few studies on the status of glycemic control in the country. Such data would be useful to allocate health resources and plan measures for instituting better control of diabetes. METHODS: The A1chieve study was an observational study of patients 66,726 with T2DM who were initiated, on or switched to, insulin analogues, alone or in combination with oral glucose lowering drugs at the discretion of their physician in accordance with local, routine clinical practice. This study reports on the participants in India from the A1chieve study. RESULTS: Baseline data of A1chieve study in 20,554 Indian T2DM patients showed that the mean HbA(1c) was 9.2%. Diabetes control was worse in those with longer duration of diabetes (9.9 +/- 5.5 years). Use of insulin was clearly suboptimal showing evidence of clinical inertia. The prevalence of both macrovascular and microvascular complications was high due to poor glycemic control. The prevalence of neuropathy was the most common complication followed by cardiovascular (23.6%), renal (21.1%) and eye (16.6%) complications. The prevalence of foot ulcer was 5.1%. Many patients had multiple complications. CONCLUSION: Glycemic control in India is poor and this has resulted in a high prevalence of complications. This emphasizes the fact that effective control of T2DM is urgently needed to prevent or reduce the risk of developing the complications of diabetes in Indian T2DM patients.
BACKGROUND: According to the ICMR-INDIAB study, there are 62.4 million people living with diabetes in India. Type 2 diabetes (T2DM) is a progressive disease and hampers the quality of life of the patients due to micro and macrovascular complications. There are few studies on the status of glycemic control in the country. Such data would be useful to allocate health resources and plan measures for instituting better control of diabetes. METHODS: The A1chieve study was an observational study of patients 66,726 with T2DM who were initiated, on or switched to, insulin analogues, alone or in combination with oral glucose lowering drugs at the discretion of their physician in accordance with local, routine clinical practice. This study reports on the participants in India from the A1chieve study. RESULTS: Baseline data of A1chieve study in 20,554 Indian T2DM patients showed that the mean HbA(1c) was 9.2%. Diabetes control was worse in those with longer duration of diabetes (9.9 +/- 5.5 years). Use of insulin was clearly suboptimal showing evidence of clinical inertia. The prevalence of both macrovascular and microvascular complications was high due to poor glycemic control. The prevalence of neuropathy was the most common complication followed by cardiovascular (23.6%), renal (21.1%) and eye (16.6%) complications. The prevalence of foot ulcer was 5.1%. Many patients had multiple complications. CONCLUSION: Glycemic control in India is poor and this has resulted in a high prevalence of complications. This emphasizes the fact that effective control of T2DM is urgently needed to prevent or reduce the risk of developing the complications of diabetes in Indian T2DM patients.
Authors: Girish M Chavan; Vivek B Waghachavare; Alka D Gore; Vishwajeet M Chavan; Randhir V Dhobale; Girish B Dhumale Journal: J Family Med Prim Care Date: 2015 Jul-Sep