Extensive studies around the world and our own data have shown that adhering to the “ABCD mantra” can prevent diabetes complications and lead to a long and healthy life. People with type 1 or type 2 diabetes can survive beyond age 60 or 70 without complications if the ABCD goals of treatment are met.
Breaking it down, “A” stands for A1c (HbA1c – glycated hemoglobin), which should be less than 7%; “B” for blood pressure, less than 140/90 mm/Hg; “C” is cholesterol (LDL – bad cholesterol), less than 100 mg/dl; “D” is discipline, including diet, physical activity, not smoking, reducing stress, and avoiding excessive alcohol consumption.
Although these targets are achievable, diabetes control targets remain suboptimal in many parts of the world, including India, where data is not available at the national level.
The Indian Council of Medical Research – India Diabetes Study (ICMR_INDIAB) is a nationally representative survey of adults aged 20 years and above, in all states and union territories. It uses a multi-state stratified sampling design in urban and rural areas. Of 1,13,043 people screened (33,537 urban and 79,506 rural), 5,789 adults with self-reported diabetes were included in the study.
The results, published in Lancet Diabetes & Endocrinology, revealed that only a third of people with diabetes (36%) in India have it under control; less than half have their blood pressure and LDL cholesterol under control; only 7.7 percent achieved all three ABC goals; there is considerable heterogeneity between regions and between states in achieving diabetes treatment goals; less than one-fifth (16.7 percent) of self-monitored glucose levels; and less than 25 percent engaged in moderate to vigorous physical activity.
This is the first national diabetes control survey in India. And his main finding is that diabetes control remains suboptimal. It is now clear that governmental and nongovernmental agencies need to raise awareness of the urgent need to improve diabetes control.
The authors are diabetologists and respectively President and CEO of Dr Mohan’s Diabetes Specialties Centre, Chennai. Views are personal
May 01, 2022