Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: Results from the DiabCare India 2011 Study.

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Abstract

DiabCare India 2011 was a cross-sectional study in patients with diabetes mellitus, undertaken to investigate the relationship between diabetes control, management and complications in a subset of urban Indian diabetes patients treated at referral diabetes care centres in India.

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Most cited references 22

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Resistance to insulin therapy among patients and providers: results of the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) study.

Torsten Lauritzen, Line Kleinebreil, Frank J. Snoek … (2005)

To examine the correlates of patient and provider attitudes toward insulin therapy. Data are from surveys of patients with type 2 diabetes not taking insulin (n = 2,061) and diabetes care providers (nurses = 1,109; physicians = 2,681) in 13 countries in Asia, Australia, Europe, and North America. Multiple regression analysis is used to identify correlates of attitudes toward insulin therapy among patients, physicians, and nurses. Patient and provider attitudes differ significantly across countries, controlling for individual characteristics. Patients rate the clinical efficacy of insulin as low and would blame themselves if they had to start insulin therapy. Self-blame is significantly lower among those who have better diet and exercise adherence and less diabetes-related distress. Patients who are not managing their diabetes well (poor perceived control, more complications, and diabetes-related distress) are significantly more likely to see insulin therapy as potentially beneficial. Most nurses and general practitioners (50-55%) delay insulin therapy until absolutely necessary, but specialists and opinion leaders are less likely to do so. Delay of insulin therapy is significantly less likely when physicians and nurses see their patients as more adherent to medication or appointment regimens, view insulin as more efficacious, and when they are less likely to delay oral diabetes medications. Patient and provider resistance to insulin therapy is substantial, and for providers it is part of a larger pattern of reluctance to prescribe blood glucose-lowering medication. Interventions to facilitate timely initiation of insulin therapy will need to address factors associated with this resistance.

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Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I.

Raj Deepa, Rajendra Pradeepa, Balaji Anitha … (2005)

To assess the prevalence of diabetic retinopathy (DR) in type 2 diabetic subjects in urban India using four-field stereo color photography. The Chennai Urban Rural Epidemiology Study (CURES) is a population-based study conducted on a representative population of Chennai (formerly Madras) city in South India. Individuals > or =20 years in age (n = 26,001) were screened for diabetes. Of the 1529 known diabetic subjects, 1382 (90.4%) participated in the study. Subjects with newly detected diabetes (n = 354) by the oral glucose tolerance test (OGTT) also consented to participate in the study. All the subjects underwent four-field stereo color photography, and retinopathy was graded in the color fundus photographs according to Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. The overall prevalence of DR in the population was 17.6% (95% confidence interval [CI]: 15.8-19.5), which included 20.8% (95% CI: 18.7-23.1) in known diabetic subjects and 5.1% (95% CI: 3.1-8.0) in subjects with newly detected diabetes. The prevalence of DR was significantly higher in men than in women (21.3% vs. 14.6%; P < 0.0001) and among subjects with proteinuria (P = 0.002). Logistic regression analysis showed that for every 5-year increase in the duration of diabetes, the risk for DR increased 1.89-fold (95% CI: 1.679-2.135; P < 0.0001). For every 2% elevation of glycated hemoglobin (HbA1c), the risk for DR increased by a factor of 1.7 (95% CI: 1.545-1.980; P < 0.0001). This study shows that the prevalence of diabetic retinopathy is lower in urban South Indians than in other ethnic groups. However, due to the large number of diabetic subjects, DR is likely to pose a public health burden in India; hence, routine retinal examination is mandatory to detect DR in the early stages.

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Prevalence of diabetic retinopathy in India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study report 2.

Rajiv Raman, Padmaja Rani, Sudhir Reddi Rachepalle … (2009)

The aim of the study was to estimate the prevalence of diabetic retinopathy in an urban Indian population older than 40 years. A population-based cross-sectional study. Five thousand nine hundred ninety-nine subjects residing in Chennai, India, were enumerated. A multistage random sampling, based on socioeconomic criteria, was followed. Identified subjects with diabetes mellitus (based on the World Health Organization criteria) underwent detailed examination at the base hospital. The fundi of all patients were photographed using 45 degrees , 4-field stereoscopic digital photography. The diagnosis of diabetic retinopathy was based on Klein's classification of the Early Treatment Diabetic Retinopathy Study scale. These included age- and gender-adjusted prevalence of diabetes and diabetic retinopathy, and correlation of prevalence with history-based risk factors. The age- and gender-adjusted prevalence rate of diabetes in an urban Chennai population was 28.2% (95% confidence interval [CI], 27.0-29.3), and the prevalence of diabetic retinopathy in general population was 3.5% (95% CI, 3.49-3.54). The prevalence of diabetic retinopathy in the population with diabetes mellitus was 18.0% (95% CI, 16.0-20.1). History-based variables that were significantly associated with increased risk of diabetic retinopathy included gender (men at greater risk; odds ratio [OR], 1.41; 95% CI, 1.04-1.91); use of insulin (OR, 3.52; 95% CI, 2.05-6.02); longer duration of diabetes (>15 years; OR, 6.43; 95% CI, 3.18-12.90); and subjects with known diabetes mellitus (OR, 2.98; 95% CI, 1.72-5.17). Differences in the socioeconomic status did not influence the occurrence of diabetic retinopathy. The prevalence of diabetic retinopathy was 18% in an urban population with diabetes mellitus in India. The duration of diabetes is the strongest predictor for diabetic retinopathy. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

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Journal

Journal ID (iso-abbrev): Indian J Endocrinol Metab

Title: Indian journal of endocrinology and metabolism

Publisher: Medknow

ISSN: 2230-8210

ISSN (Print): 2230-9500

Publication date (Electronic): May 2014

Volume: 18

Issue: 3

Affiliations

[1 ] Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India.

[2 ] Bhatia Hospital, Bombay Mutual Terrace, Mumbai, India.

[3 ] Department of Endocrinology, Lilavati and Bhatia Hospital and Grant Medical College, Mumbai, India.

[4 ] Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India.

[5 ] Formerly at Osmania University, 6-3-852/A, Ameerpet, Hyderabad, India.

[6 ] Department of Medicine, Vivekananda Institute of Medical Sciences, Kolkata, India.

[7 ] Indraprastha Apollo Hospitals, New Delhi, India.

[8 ] Diabetes Care and Research Centre, GCIB, Patna, India.

[9 ] Bharti Hospital and B.R.I.D.E., Karnal, India.

[10 ] Chellaram Diabetes Institute, Pune, India.

[11 ] Dr.S.K. Sharma's Diabetes Thyroid and Endocrine Centre, Jaipur, India.

[12 ] Nizam's Institute of Medical Sciences, Hyderabad, India.

[13 ] Clinical, Medical and Regulatory Affairs Department, Novo Nordisk India Pvt. Ltd, Bangalore, India.

[14 ] Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.

Article

Publisher Item ID: IJEM-18-370

DOI: 10.4103/2230-8210.129715

PMC ID: 4056138

PubMed ID: 24944934

SO-VID: f29c5448-51b6-46e0-b394-eace999ce20f

History

Keywords: Control and complications,DiabCare India,current status of diabetes care

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Keywords: Control and complications, DiabCare India, current status of diabetes care

Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: Results from the DiabCare India 2011 Study.

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Most cited references 22

Resistance to insulin therapy among patients and providers: results of the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) study.

Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I.

Prevalence of diabetic retinopathy in India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study report 2.

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