New Delhi, April 2019: Diabetes patients in Kolkata (East region) and Mumbai (West region) showed a slightly better control among the four selected cities representing different regions in India- with an average Haemoglobin A1c (often abbreviated as HbA1c) control of 8.35% and 8.46% respectively versus 8.56% in Chennai (South region) and 8.77% in Delhi (North region) in a Real World Evidence backed study by THB (Technology, Healthcare & Bigdata Analytics).
The study cites that~4 out of 10 diabetic patients in Delhi are living with a poor HbA1c level of more than 10%. The ADA (American Diabetes Association) guidelines recommend a target of 7% for the general population and the ICSI (Institute for Clinical Systems Improvement) guideline recommends less than 7% to less than 8% based on different patient factors).
These findings basis RWE also resonate the findings of ICMR-INDIAB study which showed that out of the four regions studied the prevalence of diabetes was highest in Chandigarh from the northern region. Highly sedentary lifestyle of the residents in the North, followed by South, West, and East was highlighted as a possible explanation (Lancet, 2017).
While there could be multiple factors driving nuances behind poor diabetes control, e.g. degree of compliance, prescription patterns, lifestyle, etc., further analysis was needed to understand the patient behaviour, and degree of compliance in these four cities from different Indian regions.
For patients with Diabetes, regular check-ups and doctor consultations can help improve their quality of life, as a tighter watch can make one aware and diligent towards their own health and, for healthcare practitioners and pharmaceutical companies- keeping track of the real state of Diabetes in India can help them put forward the right cognizance tactics in motivating the patients to follow their routine suggestive treatment. In this regard, THB, India’s leading clinical intelligence company delivering personalized care and syndicated insights, further investigated with the help of its proprietary big datasets on Indian population to derive possible reasoning behind the poor control in the country.
The analysis revealed that the percentage of patients with Diabetes revisiting healthcare providers within a period of 6 months were 36% in Delhi (Northern region), 33% in Mumbai (Western region), 27% in Chennai (Southern region) and 35% in Kolkata (Eastern region), which clearly portrayed the poor HbA1C performance in all these regions. Surprisingly, Chennai patients showed a unique behaviour- While 73% of the diabetes patients revisit a healthcare service provider after more than 6 months, they get themselves monitored comprehensively (not only diabetes markers but also screening for dyslipidaemia and/or chronic kidney disease) more often than northern and eastern regions. Not necessarily leading to the best outcomes, but that’s the preference observed.
Delhi had the lowest percentage of patients who got themselves monitored comprehensively (Diabetes parameters along with other essential health parameters). This probably explains the reason behind the worst ‘degree of diabetes control’ in the city representing Northern region.
The findings have come out from an RWE analysis from out of over 3.5 Lac diabetes patients in India including four cities representing four different regions-Delhi / NCR (North), Kolkata (East), Mumbai (West) and Chennai (South).