Real-world evidence of glycemic control among patients with type 2 diabetes mellitus in India: the TIGHT study.

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  • Author(s): Borgharkar SS;Borgharkar SS; Das SS; Das SS
  • Source:
    BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2019 Jul 14; Vol. 7 (1), pp. e000654. Date of Electronic Publication: 2019 Jul 14 (Print Publication: 2019).
  • Publication Type:
    Journal Article; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Published by BMJ in partnership with the American Diabetes Association Country of Publication: England NLM ID: 101641391 Publication Model: eCollection Cited Medium: Print ISSN: 2052-4897 (Print) Linking ISSN: 20524897 NLM ISO Abbreviation: BMJ Open Diabetes Res Care
    • Publication Information:
      Original Publication: London : Published by BMJ in partnership with the American Diabetes Association
    • Subject Terms:
      Diabetes Mellitus, Type 2/*drug therapy ; Diabetic Angiopathies/*diagnosis ; Hyperglycemia/*diagnosis ; Hypoglycemia/*diagnosis ; Hypoglycemic Agents/*adverse effects; Aged ; Biomarkers/analysis ; Blood Glucose/analysis ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/physiopathology ; Diabetic Angiopathies/chemically induced ; Diabetic Angiopathies/epidemiology ; Female ; Follow-Up Studies ; Glycated Hemoglobin/analysis ; Humans ; Hyperglycemia/chemically induced ; Hyperglycemia/epidemiology ; Hypoglycemia/chemically induced ; Hypoglycemia/epidemiology ; Incidence ; India/epidemiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors
    • Abstract:
      Objective: To determine glycemic control in adult patients with type 2 diabetes receiving antidiabetic therapy as part of routine healthcare in India.
      Research Design and Methods: This was a retrospective analysis of cross-sectional data of patients with type 2 diabetes receiving oral hypoglycemic agents (OHAs) with or without insulin between 2015 and 2017. We assessed proportion of patients with uncontrolled glycemia and performed logistic regression to evaluate its association with various risk factors and microvascular complications.
      Results: A total of 55 639 eligible records were identified; mean age of patients was 54.31 (±11.11) years. One-third of the study population had microvascular complications, predominantly neuropathy. Nearly 76.6% of patients had uncontrolled glycated hemoglobin (HbA1c) ≥7% (53 mmol/mol); 62% of these patients had HbA1c between 7% and 8% (53-64 mmol/mol). Glycemic control from combination of OHAs with or without insulin varied between 14.2% and 24.8%. In multivariate analysis, factors statistically associated with uncontrolled glycemia were obesity (OR: 1.15), hypertension (stage I OR: 1.65 and stage II OR: 2.73) and diabetes duration >5 years (OR: 1.19) (p<0.001). Similarly, the odds of having any microvascular complication increased with duration of diabetes (past 1-2 years, OR: 1.67; 2-5 years, OR: 2.53; >5 years, OR: 4.01; p<0.0001), hypertension (stage I, OR: 1.18 and stage II, OR: 1.34; p<0.05) and uncontrolled HbA1c (OR: 1.28; p<0.0001).
      Conclusions: Indian population with type 2 diabetes has a high burden (76.6%) of poor glycemic control. This study highlights the need for early implementation of optimum diabetes pharmacotherapy to maintain recommended glycemic control, thereby reducing burden of microvascular complications.
      Competing Interests: Competing interests: None declared.
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    • Contributed Indexing:
      Keywords: A1C; body mass index; hypertension; type 2 diabetes
    • Accession Number:
      0 (Biomarkers)
      0 (Blood Glucose)
      0 (Glycated Hemoglobin A)
      0 (Hypoglycemic Agents)
      0 (hemoglobin A1c protein, human)
    • Publication Date:
      Date Created: 20190816 Date Completed: 20200422 Latest Revision: 20240719
    • Publication Date:
      20240719
    • Accession Number:
      PMC6673766
    • Accession Number:
      10.1136/bmjdrc-2019-000654
    • Accession Number:
      31413840