Only 1/3rd diabetics have blood sugar under control: Lancet study

Only 1/3rd diabetics have blood sugar under control: Lancet study
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Only a third of individuals with known diabetes in India have good control over the disease, a study by the Indian Council of Medical Research (ICMR) and the Madras Diabetes Research Foundation suggested.

Published in The Lancet Diabetes and Endocrinology on Friday, the study also said that fewer than half have good control of blood pressure and LDL (bad) cholesterol, and only 7.7 percent of people with diabetes meet all three targets.

At least 36% of the population with diabetes achieved good glycemic control, 48.8% achieved good blood pressure control and 41.5% achieved LDL cholesterol control, it said.

The findings, comprising a vast sample size of 113,043 people, illustrates the scale of what are considered as non-communicable disease, which now have a growing disease burden and have been linked to unhealthy lifestyles among other factors.

The study was conducted between October 18, 2008, and December 17, 2020 and is the first extensive epidemiological study of participants from across India.

Diabetes affects more than 537 million individuals across the globe and is one of the leading causes of death worldwide. The cross-sectional, population-based survey of adults aged above 20 years and sampled 33,537 urban and 79,506 rural residents presents for the first time the status of diabetes control in the whole of India based on a nationally representative sample of 5,789 individuals with known diabetes.

For the outcome assessment, researchers defined good glycemic control as HbA1c of less than 7.0% and good blood pressure control was defined as less than 140/90 mm Hg. Good lipid control was defined as total cholesterol of less than 200 mg/dL, triglycerides of less than 150 mg/dL, LDL cholesterol of less than 100 mg/dL, and non-HDL cholesterol of less than 160 mg/dL. ABC control was defined as the proportion of individuals meeting glycaemic, blood pressure, and LDL cholesterol targets together.

Higher education, being male, residing in rural parts of the country and shorter duration of diabetes were associated with better achievement of the combined goals of diabetes treatment, the study said.

Only 36.9% of those on insulin performed any self-monitoring of blood glucose, the study showed, even though guidelines say that all such individuals should self-monitor their glucose levels regularly. As far as home monitoring is concerned, 16.7% of the population reported using a blood glucose monitor to check their blood sugar, it added.

“Our results suggest that glycemic, blood pressure and lipid control remain suboptimal in the Indian population with diabetes. As health is primarily the responsibility of each state in India, the information that our study has provided on interregional and interstate variations in the attainment of treatment targets would assist governments in formulating targeted policies for improving diabetes care delivery and surveillance in India,” Dr V Mohan, chairman of Dr Mohan’s Diabetes Specialities Centre and president of Madras Diabetes Research Foundation said. The organisation coordinated the study funded by the ICMR.

People must opt for check-ups at least once in a year as diabetes is known to be a silent killer, Dr Mohan said.

Fruits and vegetables are not consumed as much as required with less than 20% of the diabetic population reported consuming three servings of fruits and vegetables per day, the study said. The World Health Organisation recommends consuming at least five servings of fruits and vegetables a day.

Exercise is another major problem among diabetics in India, with the study showing less than 25% of people with diabetes performed moderate to vigorous physical activity.


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