title: Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: Results from the DiabCare India 2011 Study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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%).
  
  
  CONCLUSIONS
  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).
authors.affiliation: Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, India.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
authors.affiliation: Bhatia Hospital, Bombay Mutual Terrace, Mumbai, India.
authors.forename: Siddharth N
authors.initials: SN
authors.lastname: Shah
authors.affiliation: Department of Endocrinology, Lilavati and Bhatia Hospital and Grant Medical College, Mumbai, India.
authors.forename: Shashank R
authors.initials: SR
authors.lastname: Joshi
authors.affiliation: Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India.
authors.forename: V
authors.initials: V
authors.lastname: Seshiah
authors.affiliation: Formerly at Osmania University, 6-3-852/A, Ameerpet, Hyderabad, India.
authors.forename: Binode Kumar
authors.initials: BK
authors.lastname: Sahay
authors.affiliation: Department of Medicine, Vivekananda Institute of Medical Sciences, Kolkata, India.
authors.forename: Samar
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: Indraprastha Apollo Hospitals, New Delhi, India.
authors.forename: Subhash Kumar
authors.initials: SK
authors.lastname: Wangnoo
authors.affiliation: Diabetes Care and Research Centre, GCIB, Patna, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Bharti Hospital and B.R.I.D.E., Karnal, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kalra
authors.affiliation: Chellaram Diabetes Institute, Pune, India.
authors.forename: A G
authors.initials: AG
authors.lastname: Unnikrishnan
authors.affiliation: Dr.S.K. Sharma's Diabetes Thyroid and Endocrine Centre, Jaipur, India.
authors.forename: Surendra Kumar
authors.initials: SK
authors.lastname: Sharma
authors.affiliation: Nizam's Institute of Medical Sciences, Hyderabad, India.
authors.forename: P V
authors.initials: PV
authors.lastname: Rao
authors.affiliation: Clinical, Medical and Regulatory Affairs Department, Novo Nordisk India Pvt. Ltd, Bangalore, India.
authors.forename: Shahid
authors.initials: S
authors.lastname: Akhtar
authors.affiliation: Clinical, Medical and Regulatory Affairs Department, Novo Nordisk India Pvt. Ltd, Bangalore, India.
authors.forename: Raman V
authors.initials: RV
authors.lastname: Shetty
authors.affiliation: Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Das
keywords: Control and complications; DiabCare India; current status of diabetes care