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Incidence of poorly controlled diabetes highest in age group of 50-60: Metropolis’ study

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About 25 per cent of samples tested for HbA1c reported levels greater than 8 per cent, which means that their blood glucose levels are not controlled

The incidence of poorly controlled diabetes was found to be the highest in the age group of 50-60 years (about 32 per cent), followed by 60-70 years (about 29 per cent) and 40-50 years (27.6 per cent). The incidence was the lowest in the age group of 20-30 years (10 per cent) but increased steadily to peak in the age group of 50-60 years. It thereafter showed a steady decline in the older age groups.

Interestingly, 22.7 per cent of all females tested were found to suffer from poorly controlled diabetes, compared to 28 per cent for males.

Out of the more than half a million samples tested at the company’s global reference laboratory in Mumbai, almost 23 per cent were found to be in pre-diabetic stage, about 29 per cent were found to be diabetic, while 22.6 per cent tested non-diabetic.

About 25 per cent of samples tested for HbA1c reported levels greater than 8 per cent, which means that their blood glucose levels are not controlled. Prolonged high blood glucose levels put diabetic patients under risk to develop diabetes-related complications.

(Please see figures in the table below)

Commenting on the study, Dr Mayur Nigalye, Deputy Chief of Lab, Metropolis Healthcare said, “Diabetes is a growing challenge in India with estimated 8.7 per cent diabetic population in the age group of 20 and 70 years. The rising prevalence of diabetes and other non-communicable diseases is driven by a combination of factors – rapid urbanisation, sedentary lifestyles, unhealthy diets, uncontrolled use of alcohol and tobacco. Lifestyle interventions (sleep, exercise and diet modifications) along with regular monitoring is a must for diabetes management.”

For the purpose of this data analysis:

  • Data for samples tested for HbA1c was collated for over a period of five years
  • Sample data of repetitive patients were removed and only one single reading from a patient was used for the study
  • Sample was analysed by applying the reference range from 2019 ADA Guidelines

ADA 2019 Reference Range for HbA1c

  • Result ranges below 5.7 per cent – Normal
  • Result ranges between 5.7 per cent and 6.5 per cent – Prediabetes
  • Result ranges greater than 6.5 per cent and below 8 per cent – Diabetes
  • Result ranges above 8 per cent – Poorly controlled diabetes

A1C Testing – Recommendations

  • Perform the A1C test at least two times a year in patients who are meeting treatment goals (and who have stable glycemic control).
  • Perform the A1C test quarterly in patients whose therapy has changed or who are not meeting glycemic goals.
  • Point-of-care testing for A1C provides the opportunity for more timely treatment changes.

1. United Kingdom Prospective Diabetes Study Group: Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352: 837–853, 1998

2. Nutrition and lifestyle intervention in type 2 diabetes: pilot study in the Netherlands showing improved glucose control and reduction in glucose lowering medication (Pot GK, et al. bmjnph 2019;0:1–8.). British Medical Journal, Prevention and Health

Research has shown that people with type 2 diabetes who reduce their HbA1c level by 1 per cent are:

  • 19 per cent less likely to develop cataracts
  • 16 per cent less likely to have a heart condition
  • 43 per cent less likely to undergo amputation or death due to peripheral vascular disease
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