Trends in Glycemic Control Based on A1C Factorisation across Different Clinical Settings

Abstract

Approximately, 20-40% patients with diabetes achieve the glycemic target (A1C< 7%), globally. A retrospective analysis of glycemic trends based on A1C across three diabetes speciality centers [metro city (A), second tier city (B), district headquarter (C)] including 11,162 patients [A (n=3601), B (n=815), C (n=6746)] either newly diagnosed or following up at over past two years, was undertaken. Being treated as per standard guidelines with at least one HbA1c level reported within this period and classified as well-controlled (A1C <7%) or uncontrolled (A1C <7%) based on glycemic factorization. Table 1 shows the ANOVA results[1264 patients (11.32%) achieving an A1C <6%, and 2709 patients (24.27%) between 6-6.9% across centers]; representing well-controlled patients and the uncontrolled patient population (A1C>7%). The latter group with 22.52% (n=2514) and 23.49% (n=2622) patients with A1C between 7-7.9% and 8-9.9% respectively, represented a group that should be aggressively treated to mitigate the “missed opportunities” in achieving glycemic control and increase the overall percentage of patients achieving target goals. Furthermore, sub-group analyses across individual centers (A, B, C) revealed that differences in factorized HbA1c levels were statistically highly significant (p=0.002) necessitating a high-quality, uniform standard of care, irrespective of the setting to help burden of this disease. Table 1 - Glycemic Factorisation Across Three Different Diabetes Care Centers Over 24 Months.HbA1c FactorisationMetro City (A)Second Tier City (B)District Headquarter (C)TotalPercentage (%)< 626152951126411.326-6.99991871523270924.277-7.910371911286251422.528-9.99112241487262223.4910-10.9183724827376.611-11.9116303615074.54>1294596568097.25Total3601815674611162 Disclosure P.M. Chawla: Speaker's Bureau; Self; Sanofi. Speaker's Bureau; Spouse/Partner; Eli Lilly and Company, IPCA LABORATORIES, Novo Nordisk A/S, MSD PHARMACEUTICALS PVT. LTD., Boehringer Ingelheim Pharmaceuticals, Inc., AstraZeneca. C. Ashtekar: Speaker's Bureau; Self; Novo Nordisk A/S, USV Private Limited, MSD Pharmaceuticals Pvt. Ltd., Abbott, LUPIN, Eris Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, Inc., Novartis Pharmaceuticals Corporation. R.M. Dhope: Speaker's Bureau; Self; USV Private Limited, SUNPHARMA, LUPIN, Novartis Pharmaceuticals Corporation, AstraZeneca, SERDIA PHARMACEUTICALS, GLENMARK. A.F. Shaikh: None. M.C. Kothari: None. M.S. Chawla: Speaker's Bureau; Self; IPCA Laboratories, Eli Lilly and Company, Novo Nordisk A/S, MSD Pharmaceutical Pvt. Ltd., Boehringer Ingelheim Pharmaceuticals, Inc., AstraZeneca. Speaker's Bureau; Spouse/Partner; Sanofi.