Study flags poor control of blood sugar in Indians

Only over 7% of over 5,297 individuals in India with diabetes were able to achieve their blood sugar, blood pressure and cholesterol targets, according to a recent paper published. 

The latest results of the Indian Council of Medical Research (ICMR)-India Diabetes (INDIAB) study, conducted in 27 states (unified Andhra Pradesh), two Union Territories and the National Captial Territory over several rounds for the last decade, have stressed the need to have better control over various health parameters that impact mortality and quality of life.

The report “Achievement of guideline recommended diabetes treatment targets and health habits in people with self-reported diabetes in India (ICMR-INDIAB-13): a national cross-sectional study” reasons that achievement of treatment targets remains sub optimal in India, in a pan-Indian study, and goes on to provide hints for shaping the health care response to the crises. The total sample size was 1, 13,043. 

Education matters

Higher education, male sex, rural residence, and shorter duration of diabetes (under 10 years) were associated with better achievement of combined achievement of targets, said R. M. Anjana, lead author, and managing director of the Chennai-based Dr. Mohan’s Diabetes Specialties Centre that conceived and implemented the study along with ICMR and State-wise collaborators.  

Speaking at a press conference in Chennai, she added that the study used Census data for population distribution, socio-economic factors. For the outcome assessment, good glycaemic control was defined as HbA1c 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. 

Only just over 36 %, 95% CI 34·7–37·9) of 4834 people with diabetes achieved good glycaemic (blood sugar) control, over 48% achieved blood pressure control, and 41·5%, achieved good LDL cholesterol control, Dr. Anjana said. There were huge variations depending on geography, and the study results reflected the quality of care available in the region, she added. 

Follow-ups matter

V. Mohan, an author, chairman, DMDSC, stressed the importance of regular follow ups for people with diabetes, the recommended was once in three months, but it should be done at least twice a year. “In another study we realised that those who come for check up regularly over a period of 10 years, had a 50% lower risk of developing diabetic complications,” he added. 

The results of the study, of significance to each State, had been handed over to the respective State governments, Dr. Mohan explained. There is also a plan to go back and study as a follow up, the participants who had been enrolled in the trial, he said. 

Among the key interventions that the researchers indicated as possible at this stage, at a governmental level, is improving education about diabetes, and its attendant conditions, making health care easily available and accessible to all, and ensuring monitoring of the condition.

“One of the areas with considerable scope for improving adoption of health habits in individuals,” Dr. Anjana said. This would include making healthy food options available at cheap rates, instead of packaged foods. The government could also help with spreading awareness about self monitoring of various health parameters, she added. 

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