There is little information on comprehensive diabetes care comprising glycaemic, lipid, and blood pressure control in India; therefore, we aimed to assess the achievement of treatment targets among ...adults with self-reported diabetes.
The Indian Council of Medical Research (ICMR)-India Diabetes (INDIAB) study is a cross-sectional, population-based survey of adults aged 20 years or older in all 30 states and union territories of India. We used a stratified multistage sampling design, sampling states in a phased manner, and selected villages in rural areas and census enumeration blocks in urban areas. We used a three-level stratification method on the basis of geography, population size, and socioeconomic status for each state. For the outcome assessment, good glycaemic control was defined as HbA
of less than 7·0% (A), blood pressure control was defined as less than 140/90 mm Hg (B), and the LDL cholesterol target was defined as less than 100 mg/dL (C). ABC control was defined as the proportion of individuals meeting glycaemic, blood pressure, and LDL cholesterol targets together. We also performed multiple logistic regression to assess the factors influencing achievement of diabetes treatment targets.
Between Oct 18, 2008, and Dec 17, 2020, 113 043 individuals (33 537 from urban areas and 79 506 from rural areas) participated in the ICMR-INDIAB study. For this analysis, 5789 adults (2633 in urban areas and 3156 in rural areas) with self-reported diabetes were included in the study population. The median age was 56·1 years (IQR 55·7-56·5). Overall, 1748 (weighted proportion 36·3%, 95% CI 34·7-37·9) of 4834 people with diabetes achieved good glycaemic control, 2819 (weighted proportion 48·8%, 47·2-50·3) of 5698 achieved blood pressure control, and 2043 (weighted proportion 41·5%, 39·9-43·1) of 4886 achieved good LDL cholesterol control. Only 419 (weighted proportion 7·7%) of 5297 individuals with self-reported diabetes achieved all three ABC targets, with significant heterogeneity between regions and states. Higher education, male sex, rural residence, and shorter duration of diabetes (<10 years) were associated with better achievement of combined ABC targets. Only 951 (weighted proportion 16·7%) of the study population and 227 (weighted proportion 36·9%) of those on insulin reported using self-monitoring of blood glucose.
Achievement of treatment targets and adoption of healthy behaviours remains suboptimal in India. Our results can help governments to adopt policies that prioritise improvement of diabetes care delivery and surveillance in India.
Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare.
Recommendations for in-clinic PoCT for diabetes management in India Saboo, Banshi; Sadikot, Shaukat; Prasanna Kumar, K M ...
Diabetes & metabolic syndrome clinical research & reviews,
January-February 2019, 2019 Jan - Feb, 2019-01-00, 20190101, Letnik:
13, Številka:
1
Journal Article
Recenzirano
A panel of expert diabetologist clinicians developed consensus standards to address the quality gaps inclinic point of care testing (PoCT) especially pertaining to diabetes care and management in ...India. The following summarized principles were established- 1. PoCT definition, 2. Advantages and critical aspects of PoCT including guideline recommendations and accreditations, analytical factors (pre &post analytical included) and consensus reached for an ideal PoC analyzer and 3. Key recommendations on in-clinic PoCT implementation by the panel. The experts suggested next steps that included key comparative (PoCT vs NGSP accredited lab) and patient benefit studies on PoCT.
More than two billion people suffer from micronutrient deficiencies (MiNDs) globally, with nearly half living in India. The current risk of ‘hidden hunger’ is severe in India due to serious ...deficiency risks across an array of essential micronutrients. A nationwide advisory board meeting attended by more than 20 Indian health care professionals (HCPs) was conducted to determine their clinical viewpoint on MiND. An in-depth search of PubMed studies emphasizing various aspects of MiND relevant to the Indian scenario was performed and presented to eminent HCPs from across India who then shared their opinions and perspectives based on their clinical experiences associated with MiND.
•Navigating safely towards euglycemia in T2DM is a real challenge in the current clinical practice despite availability of a number of glucose-lowering drugs.•HbA1c of <7% (53 mmol/mol) is an ...effective and safe target for euglycemia in non-pregnant adults; Glycemic targets should be individualized in special patient population.•Amongst the sulfonylureas, gliclazide is effective and safe in navigating towards euglycemia in type 2 diabetes.•Every patient with T2DM has the right to achieving euglycemia with minimal constraints.
Navigating safely towards euglycemia in type 2 diabetes mellitus (T2DM) is a real challenge in the current clinical practice despite availability of a number of glucose-lowering drugs; major barriers are hypoglycemia and weight gain. Sulfonylureas (SUs) have been recommended as one of the most common choice of add-on therapy to metformin (used as first line therapy). They are used extensively in Southeast Asia due to their high efficacy and low cost. However, there have been concerns regarding hypoglycemia, weight gain and cardiovascular safety with SUs. There is a need for an oral molecule that does not cause weight gain, has low risk of causing hypoglycemia, which can be used to navigate safely towards euglycemia with minimal constraints. Literature has shown that gliclazide provides consistent glycemic control with fewer hypoglycemic episodes and has long-term micro- and macrovascular benefits. This expert opinion was developed to highlight the role of SUs, and gliclazide in particular, in navigating effectively and safely towards the desired glycemic control in T2DM.
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