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Year : 2012  |  Volume : 16  |  Issue : 8  |  Page : 430-431

Improving management practices and clinical outcomes in type 2 diabetes study: Prevalence of complications in people with type 2 diabetes in India

1 Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India
2 Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Aminjikarai, Chennai, India
3 Department of Medicine, Osmania Medical College, Ameerpet, Hyderabad, India
4 Diabetes Care and Research Centre, GCIB, Patna, India
5 Department of Diabetology, Government Rajaji Medical College, Madurai, India
6 Diabetes Care & Research Institute, Aminjikarai, Chennai, India
7 Bharti Hospital & B.R.I.D.E., Karnal, India
8 Novo Nordisk India Pvt. Ltd., Bangalore, Karnataka, India
9 Institute of Diabetology, Madras Medical College, Chennai, India

Correspondence Address:
Ashok Kumar Das
Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2230-8210.104119

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Introduction: Diabetes is the fourth leading cause of disease-related death and almost 80% of diabetes-related deaths occur in developing countries. Optimal glycemic control, in particular HbA1c level less than 7% with effective management of dyslipidemia and hypertension can reduce development of diabetes-related complications. Delay in initiating/or optimizing appropriate anti-diabetic therapy including insulin could be a possible cause of the increase in complications. Method: Improving management practices and clinical outcomes in type 2 diabetes (IMPACT) was a prospective, open-label, 26-week, comparative, multi-center study to compare efficacy and safety of the Indian insulin guideline (IIG) group versus routine clinical practice (RCP) group in type 2 diabetes patients. A total of 20,653 subjects from 885 centers across India were enrolled. Results: A total of 4695 patients (22.7%) (IIG, 4113 [22.6%]; RCP, 582 [23.5%]) had macrovascular complications and 8640 patients (41.8%) (IIG, 7486 [41.2%]; RCP, 1154 [46.6%]) had microvascular complications. Of 4695 patients with macrovascular complications, 2850 patients (60.7%) had coronary heart disease followed by 1457 patients (31.0%) with peripheral vascular disease. Of all the microvascular complications recorded, 5627 patients (65.1%) had peripheral neuropathy followed by 3313 patients (38.3%) with retinopathy. Conclusion: The rates of complications were high in patients with type 2 diabetes at the time of being initiated on insulin therapy in India.

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