No Improvement in Glycemic Control or Rates of Diabetes-Related Complications for People with Type 2 Diabetes—Results from 10 Years of the International Diabetes Management Practices Study (IDMPS)

Abstract

Diabetes treatment has evolved over the last decade. During this time, the IDMPS, a global observational survey on the management and patterns of care of people with type 1 and type 2 (T2D) diabetes in the developing world, has collected data in 7 individual waves. Each wave enrolled different participants. We report the glycemic condition and the frequency of diabetes-related cardiovascular complications in participants with T2D observed between 20and 2017 in 48 countries across Africa, the Middle East, South Asia, Latin America, Asia, and Eurasia. From Wave 1 to Wave 7, no improvement in the proportion of people achieving HbA1c <7% was seen. This is the case for all groups, i.e., those receiving oral glucose-lowering drugs (OGLDs) plus injectable treatments, and those receiving insulin (Table). The proportions of participants with micro- and macrovascular complications appear relatively unchanged. Throughout all waves, the proportion of participants receiving insulin remained constant (≈20%). For those treated with OGLDs plus basal insulin, the median daily dose of insulin was 0.21 U/kg in 20and 0.32 U/kg in 2017; over the same period, the median BMI at diagnosis increased from 26 kg/m2 to 29 kg/m2. This lack of progress highlights the continued need for improvements in diabetes management and education. Disclosure P. Aschner: Other Relationship; Self; Sanofi. J.J. Gagliardino: Other Relationship; Self; Sanofi. H.M. Ilkova: Advisory Panel; Self; Abbott, Eli Lilly and Company, Novartis AG, Novo Nordisk A/S, Boehringer Ingelheim GmbH, Servier, Merck Sharp & Dohme Corp.. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Medtronic, Roche Diabetes Care Health and Digital Solutions, Bilim İlac. F.J. Lavalle-Gonzalez: Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Research Support; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Novo Nordisk Inc.. Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Research Support; Self; AstraZeneca. Advisory Panel; Self; Merck Sharp & Dohme Corp.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Abbott. Speaker's Bureau; Self; Abbott. A. Ramachandran: None. G. Kaddaha: Other Relationship; Self; Sanofi. J. Mbanya: Advisory Panel; Self; GlaxoSmithKline plc.. Speaker's Bureau; Self; Novo Nordisk A/S, Sanofi, Servier. M.V. Shestakova: None. J. Chantelot: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. J.C. Chan: Consultant; Self; Bayer AG. Other Relationship; Self; Bayer AG. Consultant; Self; Sanofi. Other Relationship; Self; Sanofi, Eli Lilly and Company, Amgen Inc.. Consultant; Self; AstraZeneca, Merck & Co., Inc., Pfizer Inc.. Other Relationship; Self; Pfizer Inc.. Board Member; Self; Asia Diabetes Foundation. Stock/Shareholder; Self; GemVCare. Other Relationship; Self; Merck Sharp & Dohme Corp.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Novartis AG, Eli Lilly and Company.