A nationwide study funded by the Indian Council of Medical Research and coordinated by the Madras Diabetes Research Foundation, has found that only a third of individuals with known diabetes in India have good control of diabetes, fewer than half have good control of blood pressure and LDL (bad) cholesterol, and only 7.7% meet all three targets. The study, comprising a vast sample size of 113, 043 people across 30 States and Union Territories of India, is the first extensive epidemiological study consisting of participants from all across the country. The results of the study have been published in The Lancet Diabetes and Endocrinology.
The cross-sectional, population-based survey of adults aged ≥20 years and sampled 33,537 urban and 79,506 rural residents in 30 States and Union Territories of the country using a stratified, multistage sampling design. The study 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.
The study revealed that:
36.3% of the population with diabetes achieved good glycemic control, 48.8% achieved good blood pressure control and 41.5% achieved LDL cholesterol control.
Higher education, male sex, rural residence and shorter duration of diabetes were associated with better achievement of the combined goals of diabetes treatment.
16.7% of the population reported using a blood glucose monitor to check their blood sugars at home. Only 36.9% of those on insulin performed any self-monitoring of blood glucose, notwithstanding the guidelines that all such individuals should self-monitor their glucose levels regularly.
Less than 20% of the diabetes population reported consuming three servings of fruits and vegetables per day (compared to the WHO recommendation of five servings a day)
Less than 25% of people with diabetes performed moderate to vigorous physical activity.
Dr. R. M. Anjana, the Managing Director, Dr.Mohan’s Diabetes Specialities Centre and Vice President, Madras Diabetes Research Foundation and the first author of the study said, “The findings of this study are very significant as they provide new data on the achievement of diabetes treatment goals, such as HbA1c, blood pressure and LDL cholesterol in a population based nationally representative study in India. We found that a third of individuals with self-reported diabetes have good glycemic control and fewer than half have good blood pressure control and LDL cholesterol, with considerable heterogeneity between regions and states. There is, therefore, an urgent need to improve awareness regarding a healthy diet and importance of physical activity among the Indian population by governmental and non-governmental agencies.”
Dr. V. Mohan, Chairman, Dr.Mohan’s Diabetes Specialities Centre and President, Madras Diabetes Research Foundation and senior author of the study adds “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”.
The findings of the study imply that the achievement of treatment goals and adoption of healthy behaviors remains suboptimal in India. The findings underscore the need for better control of glycemia, blood pressure and lipid parameters, so as to reduce the risk of diabetes related complications in Indians. These results can help both the Central and State Government formulate policies to improve diabetes care at the primary, secondary and tertiary levels in India.