Diabetes is still poorly controlled in India owing to delays in early detection and proper treatment,says a five-year survey involving 1,755 Indian participants. With an estimated figure of 40.9 million diabetics,India is the diabetes capital of the world,followed by China and the United States. The World Health Organisation (WHO) estimates the number of diabetics to exceed 350 million by 2030. Governments and other healthcare providers around the world are investing in health education,diagnosis and treatments for this chronic,debilitating – but controllable disease.
Dr A Ramachandran,Global Steering Committee member of The International Diabetes Management Practices Study (IDMPS),says that that the Sanofi-Aventis had conducted a five-year survey documenting changes in diabetes practice in developing regions,including India. The two-part multinational,multi-center,observational study was carried out in 27 countries in Africa,Asia,Eastern Europe,the Middle East and Latin America. It was started in 2005 and will conclude in 2010. A total of 11,800 patients were included for the study. Of these 1898 were Type 1 diabetes and 9901 were Type 2 diabetes patients.
While proper management and timely treatment of diabetes can reduce death and complication rates,multiple barriers in treatment protocol can come in the way of this process. Most diabetic patients reside in developing countries where standardised data on quality of care is relatively scarce. After smoking,diabetes is the major cause of heart disease in India. The onset of diabetes in Indians is significantly early compared to their Western counterparts. Most Indian Type 1(T1) and Type 2 Diabetes Mellitus (T2DM) patients do not achieve the treatment goals as per international guidelines laid down by American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD). Our study shows that most Indian patients do not achieve the recommended HbA1c and FBG (fasting blood glucose) levels and have poor laboratory and self monitoring blood glucose levels. According to the guidelines,DM patients ought to test their HbA1c levels at least two times a year if they are meeting treatment goals and quarterly for whose therapy has changed or who are not meeting glycemic goals. He added,We have found that on an average Indian T1DM and T2DM patients take the test 2.4 times and 2.1 times every two years respectively. This highlights the indifferent attitude of the patients themselves.
The first cross-sectional study period assessed 116 Indian patients with Type-1 Diabetes with a mean diabetes duration of seven years and 1639 Indian patients with Type 2 Diabetes for an average of eight years. Among type 1 diabetes patients 33.6 per cent had at least one diabetic complication,of which 100 per cent had microvascular and 17.9 per cent had macrovascular complications. Among type 2 diabetes patients,48 per cent had atleast one complication of whom 89.5 per cent had microvascular complications and 42.1 per cent had macrovascular complications.