Mohan Viswanathan, Shah Siddharth N, Joshi Shashank R, Seshiah V, Sahay Binode Kumar, Banerjee Samar, Wangnoo Subhash Kumar, Kumar Ajay, Kalra Sanjay, Unnikrishnan A G, Sharma Surendra Kumar, Rao P V, Akhtar Shahid, Shetty Raman V, Das Ashok Kumar
Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India.
Bhatia Hospital, Bombay Mutual Terrace, Mumbai, India.
Indian J Endocrinol Metab. 2014 May;18(3):370-8. doi: 10.4103/2230-8210.129715.
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.
This was a cross-sectional, multicentre (330 centres) survey in 6168 diabetes patients treated at general hospitals, diabetes clinics and referral clinics across India. Patient data, including medical and clinical examination reports during the past year were collected during their routine visit. The patients' and physicians' perceptions about diabetes management were recorded using a questionnaire.
A total of 6168 subjects with diabetes (95.8% type 2), mean age 51.9 ± 12.4 years and mean duration of diabetes, 6.9 ± 6.4 years were included. Mean HbA1c was 8.9 ± 2.1% and the mean fasting (FPG), post prandial (PPG) and random (RBG) plasma glucose levels were 148 ± 50 mg/dl 205 ± 66 mg/dl and 193 ± 68mg/dl respectively. Neuropathy was the most common complication (41.4%); other complications were: Foot (32.7%), eye (19.7%), cardiovascular (6.8%) and nephropathy (6.2%). The number of diabetic complications increased with mean duration of diabetes. Most (93.2%) of the patients were on oral anti-diabetic drugs (OADs) and 35.2% were on insulin (±OADs). More than 15% physicians felt that the greatest barrier to insulin therapy from patient's perspective were pain and fear of using injectable modality; 5.2% felt that the greatest barrier to insulin therapy from physician's perspective was the treatment cost; 4.8% felt that the major barriers to achieve optimum diabetic care in practice was loss to follow-up followed by lack of counselling (3.9%) and treatment compliance (3.6%).
DiabCare India 2011 has shown that type 2 diabetes sets in early in Indians and glycaemic control is often sub-optimal in these patients. These results indicate a need for more structured intervention at an early stage of the disease and need for increased awareness on benefits of good glycaemic control. It cannot be overemphasized that the status of diabetes care in India needs to be further improved. (ClinTrials.gov identifier: NCT01351922).
“印度糖尿病护理2011”是一项针对糖尿病患者的横断面研究，旨在调查印度转诊糖尿病护理中心治疗的部分城市糖尿病患者的血糖控制、管理与并发症之间的关系。
这是一项横断面、多中心（330个中心）调查，涉及印度各地综合医院、糖尿病诊所和转诊诊所治疗的6168例糖尿病患者。在患者常规就诊期间收集其过去一年的患者数据，包括医学和临床检查报告。使用问卷记录患者和医生对糖尿病管理的看法。
共纳入6168例糖尿病患者（95.8%为2型糖尿病），平均年龄51.9±12.4岁，平均糖尿病病程6.9±6.4年。平均糖化血红蛋白（HbA1c）为8.9±2.1%，平均空腹血糖（FPG）、餐后血糖（PPG）和随机血糖（RBG）水平分别为148±50mg/dl、205±66mg/dl和193±68mg/dl。神经病变是最常见的并发症（41.4%）；其他并发症包括：足部（32.7%）、眼部（19.7%）、心血管（6.8%）和肾病（6.2%）。糖尿病并发症的数量随糖尿病平均病程增加。大多数患者（93.2%）使用口服降糖药（OADs），35.2%使用胰岛素（±OADs）。超过15%的医生认为，从患者角度看，胰岛素治疗的最大障碍是疼痛和对注射方式的恐惧；5.2%的医生认为，从医生角度看，胰岛素治疗的最大障碍是治疗费用；4.8%的医生认为，在实际中实现最佳糖尿病护理的主要障碍是失访，其次是缺乏咨询（3.9%）和治疗依从性（3.6%）。
“印度糖尿病护理2011”表明，2型糖尿病在印度人身上发病较早，这些患者的血糖控制往往不理想。这些结果表明在疾病早期需要更有组织的干预，并且需要提高对良好血糖控制益处的认识。必须强调的是，印度糖尿病护理的现状需要进一步改善。（临床研究标识符：NCT01351922）
