Kalra Sanjay, Saboo Banshi, Sahay Rakesh, Khandelwal Deepak, Talwar Vipin, Unnikrishnan A G
Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India.
Department of Medicine, DiaCare, Ahmedabad, Gujarat, India.
Indian J Endocrinol Metab. 2017 Jan-Feb;21(1):242-244. doi: 10.4103/2230-8210.196027.
This communication hypothesises a rule of two thirds which seems to operate in Indian diabetes epidemiology. Two thirds of all persons with dysglycemia are prediabetic; two thirds of all persons with diabetes are diagnosed to have the condtion; and two thirds are diagnosed before the age of 50 years. Two thirds of people with diabetes have concomitant hypetension or dyslipidemia; two thirds do not get their HbA1c assessed; and two thirds of those who do, do not achiev target values. Yet, two thirds of people with diabetes report satisfactory psychosocial health and quality of life, and adherence to dietary therapy and medication. Only one thirds adhere to exercise and self monitoring advice, however. Two thirds of persons on oral glucose lowering drugs receive metformin; two thirds of those on insulin receive premixed insulin or twice daily isnuslin, and a similar proportion uses pens for delivery. Thus, the rule of two thirds, rather than of halves, operates in modern Indian diabetes practice.
本通讯提出了一个似乎在印度糖尿病流行病学中起作用的三分之二规则。所有血糖异常者中有三分之二处于糖尿病前期；所有糖尿病患者中有三分之二被诊断患有该病；并且三分之二在50岁之前被诊断出来。三分之二的糖尿病患者伴有高血压或血脂异常；三分之二的患者未进行糖化血红蛋白（HbA1c）评估；而在进行评估的患者中，有三分之二未达到目标值。然而，三分之二的糖尿病患者报告心理社会健康状况和生活质量良好，并且坚持饮食治疗和药物治疗。不过，只有三分之一的患者坚持运动和自我监测建议。三分之二口服降糖药的患者使用二甲双胍；三分之二使用胰岛素的患者接受预混胰岛素或每日两次的胰岛素注射，并且有类似比例的患者使用胰岛素笔进行注射。因此，在现代印度糖尿病实践中起作用的是三分之二规则，而非二分之一规则。
