No abstract

Background: High rates of diabetes have been reported throughout urban India, though limited data exists concerning the prevalence of diabetes in rural areas, where 70% of the population resides. Socioeconomic and cultural differences may necessitate a different approach towards the treatment and prevention of diabetes in rural as opposed to urban areas. Objective: The aim of this study was to evaluate the efficacy of a novel, community-centered model in rural villages of Hyderabad, India over the course of 6 months and compare results to traditional methods currently used by rural clinics in Ahmedabad, India. Methods: As opposed to traditional methods that rely on direct patient-provider interaction, our community-centered method relied on a four-tier system consisting of providers, leaders of each village, “ambassadors” within each village, and patients. A total of 1,013 individuals aged ≥ 25 years (mean age 47.2 years) were sampled at random gender and age from 12 villages in Hyderabad and Ahmedabad. Vitals were taken and blood glucose was measured in all participants using a GlucoSpark glucometer. Baseline statistics were similar for both populations. Results: In villages surrounding Hyderabad, the prevalence of diabetes was 9.6% (95% CI 7.2-11.9), of which 6.2% (5.1-7.3) were known cases and 3.4% (2.2-4.6) had not previously been diagnosed. The prevalence of diabetes in Ahmedabad was determined to be 12.9% (10.8-15.1), with 5.2% (3.8-6.6) diagnosed and 7.7% (6.2-8.2) previously undiagnosed. Notably, average glucose levels in the Hyderabad population were significantly lower than in the Ahmedabad population after 6 months (t=3.3, p<0.001). Conclusion: While this study is not representative of rural India as a whole, it highlights the importance of community-centered health in rural settings. Findings suggest that approaches towards diabetes treatment, prevention, and education should vary with patient populations and be considered carefully. Disclosure S. Shah: None. K. Prasad: None. B.D. Saboo: None. S. Shah: None. D. Hasnani: None. V. Chavda: None. K. Hcb: None. R.K. Meruva: None.

No abstract

Background: Many studies have estimated the prevalence of type 2 diabetes in suburban regions of India, such as Ahmedabad, Gujarat. However, there are few studies that examine the progression of HbA1C levels in patients diagnosed with diabetes over multiple visits to healthcare facilities. Objective: The primary aims of this study were to assess the efficacy of patient treatment at a diabetes care center in Gujarat, India and determine factors that may affect the progression of HbA1C levels over multiple visits. Methods: A total of 2,037 individuals aged ≥25 years (mean age 53.7 years) were included in this retrospective study. All individuals were previously diagnosed with diabetes and received treatment at the Dia Care Advanced Diabetes Care Center in Ahmedabad. Patient data was acquired from the clinic’s HealthPlix EMR. Results: Of those meeting inclusion criteria, males constituted 69.1%. The average BMI of all subjects was 29.7 kg/m2. Of all 2,037 subjects, only 22.0% (n=442) patients were tested for HbA1C levels multiple times. On average, these subjects underwent blood tests for HbA1C values 3.3 times in a one-year period and HbA1C levels dropped by 0.51 mg/dl (95% CI 0.70-0.31). There was a substantial correlation between the number of clinic visits and the decrease in HbA1C values (R = 0.71). Over the course of one year, 22.6% (19.9-25.1) of subjects who returned to the clinic saw a drop in HbA1C to levels not indicative of diabetes (≤6.5 mg/dl). A significant correlation was observed between RBS measurements and HbA1C levels. Notably, there was also a slight negative correlation between BMI and the number of clinic visits (R = 0.74). Conclusion: Results from this study reinforce the conventional wisdom that frequent visits to one’s physician help achieve glycemic control. More importantly, these results also reflect the success of suburban clinics such as Dia Care and call for physicians to stress the importance of clinic visits and address improvement in metabolic status regularly. Disclosure S. Shah: None. B.D. Saboo: None. S. Shah: None. D. Hasnani: None. V. Chavda: None. J. Kesavadev: Speaker’s Bureau; Self; Biocon, Novo Nordisk Inc., Sanofi-Aventis. H.B. Shah: None. K.J. Patel: None.