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ORIGINAL ARTICLE
Year : 2014  |  Volume : 18  |  Issue : 3  |  Page : 370-378

Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: Results from the DiabCare India 2011 Study


1 Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India
2 Bhatia Hospital, Bombay Mutual Terrace, Mumbai, India
3 Department of Endocrinology, Lilavati and Bhatia Hospital and Grant Medical College, Mumbai, India
4 Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India
5 Formerly at Osmania University, 6-3-852/A, Ameerpet, Hyderabad, India
6 Department of Medicine, Vivekananda Institute of Medical Sciences, Kolkata, India
7 Indraprastha Apollo Hospitals, New Delhi, India
8 Diabetes Care and Research Centre, GCIB, Patna, India
9 Bharti Hospital and B.R.I.D.E., Karnal, India
10 Chellaram Diabetes Institute, Pune, India
11 Dr.S.K. Sharma's Diabetes Thyroid and Endocrine Centre, Jaipur, India
12 Nizam's Institute of Medical Sciences, Hyderabad, India
13 Clinical, Medical and Regulatory Affairs Department, Novo Nordisk India Pvt. Ltd, Bangalore, India
14 Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
15 ,

Correspondence Address:
Shahid Akhtar
Novo Nordisk India Private Ltd., Plot No. 32, 47-50, EPIP Area, Whitefi eld, Bangalore - 560 066, Karnataka
India
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Source of Support: DiabCare India 2011 Study was sponsored by Novo Nordisk India, Conflict of Interest: Shahid Akhtar and Raman V Shetty are employees of Novo Nordisk. Other authors declare no conflict of interest pertaining to this publication


DOI: 10.4103/2230-8210.129715

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Objectives: DiabCare India 2011 was a cross-sectional study in patients with diabetes mellitus, undertaken to investigate the relationship between diabetes control, management and complications in a subset of urban Indian diabetes patients treated at referral diabetes care centres in India. Materials and Methods: This was a cross-sectional, multicentre (330 centres) survey in 6168 diabetes patients treated at general hospitals, diabetes clinics and referral clinics across India. Patient data, including medical and clinical examination reports during the past year were collected during their routine visit. The patients' and physicians' perceptions about diabetes management were recorded using a questionnaire. Results: A total of 6168 subjects with diabetes (95.8% type 2), mean age 51.9 ± 12.4 years and mean duration of diabetes, 6.9 ± 6.4 years were included. Mean HbA1c was 8.9 ± 2.1% and the mean fasting (FPG), post prandial (PPG) and random (RBG) plasma glucose levels were 148 ± 50 mg/dl 205 ± 66 mg/dl and 193 ± 68mg/dl respectively. Neuropathy was the most common complication (41.4%); other complications were: Foot (32.7%), eye (19.7%), cardiovascular (6.8%) and nephropathy (6.2%). The number of diabetic complications increased with mean duration of diabetes. Most (93.2%) of the patients were on oral anti-diabetic drugs (OADs) and 35.2% were on insulin (±OADs). More than 15% physicians felt that the greatest barrier to insulin therapy from patient's perspective were pain and fear of using injectable modality; 5.2% felt that the greatest barrier to insulin therapy from physician's perspective was the treatment cost; 4.8% felt that the major barriers to achieve optimum diabetic care in practice was loss to follow-up followed by lack of counselling (3.9%) and treatment compliance (3.6%). Conclusion: DiabCare India 2011 has shown that type 2 diabetes sets in early in Indians and glycaemic control is often sub-optimal in these patients. These results indicate a need for more structured intervention at an early stage of the disease and need for increased awareness on benefits of good glycaemic control. It cannot be overemphasized that the status of diabetes care in India needs to be further improved. (ClinTrials.gov identifier: NCT01351922)


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