Kolkata shows better control on diabetes in India: RWE study

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 per cent and 8.46 per cent respectively versus 8.56 per cent in Chennai (south region) and 8.77 per cent in Delhi (north region) in a Real World Evidence-backed study by clinical intelligence company delivering personalised care and insights Technology, Healthcare & Bigdata Analytics (THB).

The study cites that four out of 10 diabetic patients in Delhi are living with a poor HbA1c level of more than 10 per cent. The ADA (American Diabetes Association) guidelines recommend a target of seven per cent for the general population and the ICSI (Institute for Clinical Systems Improvement) guideline recommends less than seven to eight per cent based on different patient factors.

These findings on the basis of 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 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 patients with diabetes revisiting healthcare providers within a period of six months were 36 per cent in Delhi (northern region), 33 per cent in Mumbai (western region), 27 per cent in Chennai (southern region) and 35 per cent in Kolkata (eastern region), which portrayed the poor HbA1C performance in all these regions. Surprisingly, patients from Chennai showed a unique behaviour- while 73 per cent of the diabetes patients revisit a healthcare service provider after more than six 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.

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 lakh diabetes patients in the four metro cities.