Lack of awareness regarding blood sugar monitoring and glucose control
In a recent national survey conducted by Abbott and the Association of Physicians of India among 1,500 adults with uncontrolled diabetes, 90% of respondents believe that they have control over their glucose levels, despite facts suggesting otherwise. The respondents were in the 18 to 65 years age group. The survey also covered 302 caregivers and 60 doctors in India.
The prevalence of diabetes in India is the second largest in the world and continues to rise. According to the International Diabetes Federation (IDF), India’s population of people living with diabetes today is 65.1 million, compared with 50.8 million in 2010. That number is expected to exceed 100 million by 2030. The economic burden due to diabetes in India is among the highest in the world and studies in India estimate that, for a low income Indian family with an adult with diabetes, as much as 25% of family income may be devoted to diabetes care.
The Abbott Sugar Survey highlighted the need for better diabetes management to help people with diabetes in India live healthier lives.
Some 92% of people with uncontrolled diabetes in Mumbai believe their blood sugar is actually under control, while 43% of diabetics in the city suffer from symptoms of hypoglycemia at night, late after dinner, according to the survey. But only 10% of respondents in Mumbai believed monitoring was important compared with 20% to 30% respondents in Delhi, Chennai, Hyderabad and Pune.
Uncontrolled diabetes is defined as having HbA1c greater than 7 – a globally accepted measurement for indicating how well glucose levels are being managed.
More than 50% people with diabetes (mostly females) believe that diabetes has had an impact on their personal life, while males with diabetes believe the condition affects professional life due to exhaustion and fatigue. Women are also more aware about the impact of diabetes than men. Around 54% of respondents experienced at least one complication because of poor blood sugar control, while 55% people in Mumbai recall suffering from at least one complication.
Among those who face complications, fluctuating glucose levels is the biggest issue feared. Very low and high sugar levels was a top worry among five out of 10 respondents in Mumbai. At the same time, seven out of 10 respondents in Mumbai believed that their sugar levels do not change constantly throughout the day.
One in three respondents experienced hypoglycemia or hyperglycemia, and more than 75% of respondents worry about recurrence, especially in the age group of 35 and above, the survey showed.
The majority of hypoglycaemic incidents occur either late at night after dinner, on missing a meal, or while dieting or even fasting. Non-compliance of diet, medication or exercise were cited as the top three reasons by respondents and caregivers for not effectively managing diabetes. Though patients, doctors and caregivers considered monitoring sugar levels as a key factor in control and management of diabetes, 50% of respondents monitor their sugar levels only once in three months, compared with the twice-daily recommended in guidelines. Despite the inadequate monitoring, 40% of the respondents said that they adjust the dose of their medicines themselves to manage their diabetes.
Findings also pointed to the need to drive education that uncontrolled diabetes can ultimately lead to additional health complications and the need for better management of diabetes. Poor glycemic control puts people at increased risk of neuropathy (24.6%), cardiovascular complications (23.6%), kidney problems (21.1%), retinopathy (16.6%) and foot ulcers (5.5%).
'With diabetes already at epidemic proportions, it is time for people to start taking better control of their blood glucose levels,' said Shashank R Joshi, a leading endocrinologist and diabetologist and President of the Association of Physicians of India.
'The biggest challenge is that people with diabetes do not have all the tools they need to be able to connect the consequences of uncontrolled diabetes with the impact on their bodies. While people with diabetes feel all is well, uncontrolled diabetes leads to heart disease, or eye, kidney or nerve problems. Better awareness and effective control of diabetes can help prevent or reduce the risk of people with diabetes developing these complications,' he said.
Dilip Rajan, Country Head and General Manager of Abbott's diabetes care business, said: 'Through this research, Abbott is seeking to advance understanding and increase awareness and support for better diabetes management in India, so that ultimately, we can help people with diabetes do more, achieve more and experience more in their lives.'
The study was conducted across eight cities in Mumbai, Delhi, Kolkata, Chennai, Bangalore, Ahmedabad, Hyderabad and Pune, and segmented respondents based on different factors, such as gender, occupation, type of diabetes and age. All people with diabetes recruited for the survey had HbA1c levels of 7 and above and had been living with diabetes for at least a year.