Unnikrishnan Ranjit, Anjana Ranjit Mohan, Deepa Mohan, Pradeepa Rajendra, Joshi Shashank R, Bhansali Anil, Dhandania Vinay K, Joshi Prashant P, Madhu Sri Venkata, Rao Paturi Vishnupriya, Lakshmy Ramakrishnan, Jayashri Ramamurthy, Velmurugan Kaliaperumal, Nirmal Elangovan, Subashini Radhakrishnan, Vijayachandrika Venkataraman, Kaur Tanvir, Shukla Deepak Kumar, Das Ashok Kumar, Mohan Viswanathan
1 Department of Epidemiology & Diabetology, Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre , Chennai, India .
Diabetes Technol Ther. 2014 Sep;16(9):596-603. doi: 10.1089/dia.2014.0018. Epub 2014 Aug 7.
This study estimated the levels of glycemic control among subjects with self-reported diabetes in urban and rural areas of four regions in India.
Phase I of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) Study was conducted in a representative population of three states of India (Tamil Nadu, Maharashtra, and Jharkhand) and one Union Territory (Chandigarh) and covering a population of 213 million people. Using a stratified multistage sampling design, individuals ≥20 years of age were recruited. Glycemic control among subjects with self-reported diabetes was assessed by measurement of glycated hemoglobin (HbA1c), estimated by the Variant™ II Turbo method (Bio-Rad, Hercules, CA).
Among the 14,277 participants in Phase I of INDIAB, there were 480 subjects with self-reported diabetes (254 urban and 226 rural). The mean HbA1c levels were highest in Chandigarh (9.1±2.3%), followed by Tamil Nadu (8.2±2.0%), Jharkhand (8.2±2.4%), and Maharashtra (8.0±2.1%). Good glycemic control (HbA1c <7%) was observed only in 31.1% of urban and 30.8% of rural subjects. Only 22.4% of urban and 15.4% of rural subjects had reported having checked their HbA1c in the past year. Multiple logistic regression analysis revealed younger age, duration of diabetes, insulin use, and high triglyceride levels to be significantly associated with poor glycemic control.
The level of glycemic control among subjects with self-reported diabetes in India is poor. Urgent action is needed to remedy the situation.
本研究评估了印度四个地区城乡自我报告患有糖尿病的受试者的血糖控制水平。
印度医学研究理事会 - 印度糖尿病（ICMR - INDIAB）研究的第一阶段在印度三个邦（泰米尔纳德邦、马哈拉施特拉邦和贾坎德邦）和一个联邦属地（昌迪加尔）的代表性人群中进行，覆盖人口达2.13亿。采用分层多阶段抽样设计，招募年龄≥20岁的个体。通过测量糖化血红蛋白（HbA1c）评估自我报告患有糖尿病的受试者的血糖控制情况，HbA1c采用Variant™ II Turbo方法（伯乐公司，美国加利福尼亚州赫拉克勒斯）进行估算。
在INDIAB研究第一阶段的14277名参与者中，有480名自我报告患有糖尿病的受试者（254名城市受试者和226名农村受试者）。糖化血红蛋白平均水平最高的是昌迪加尔（9.1±2.3%），其次是泰米尔纳德邦（8.2±2.0%）、贾坎德邦（8.2±2.4%）和马哈拉施特拉邦（8.0±2.1%）。仅31.1%的城市受试者和30.8%的农村受试者血糖控制良好（糖化血红蛋白<7%）。仅22.4%的城市受试者和15.4%的农村受试者报告在过去一年中检查过糖化血红蛋白。多因素logistic回归分析显示，年龄较小、糖尿病病程、使用胰岛素和高甘油三酯水平与血糖控制不佳显著相关。
印度自我报告患有糖尿病的受试者的血糖控制水平较差。需要采取紧急行动来改善这种情况。
