Jaipur, 11th May, 2020.

The latest findings of India Diabetes Care Index (IDCI®) suggest that glycosylated hemoglobin or HbA1c level increased from 8.20% to 8.50%during January to March 2020 as compared to the previous quarter in Jaipur. The rise in HbA1C level comes at a time when medical studies are pointing towards an increased risk for severe complications arising from COVID-19 in people living with diabetes. The India Diabetes Care Index, a part of the ‘Impact India: 1000-Day Challenge’ programme by Novo Nordisk Education Foundation studies the blood glucose levels across cities through various parameters.

The HbA1c test indicates the average blood glucose level over a period of three months and is considered as one of the best recommended indicators of long-term blood glucose control. People who were part of the assessment in Jaipur had an average age of 56 years, out of which 61% were male and 39% were female. Furthermore, the average postprandial glucose level was 257 mg/dl in the quarter and the average fasting glucose level was171 mg/dl. 

People living with diabetes are more likely to experience severe symptoms and complications if they get infected with COVID-19 and this may even worsen if their diabetes is not managed well. Also, in the long run, it should be noted that 1% reduction in HbA1c reduces the risk of diabetes-related complications including the risk of heart failure by 16% and the risk of heart attack by 14%. Older adults and people with pre-existing medical conditions like hypertension, heart disease, pulmonary disorders and obesity related conditions are also at a higher risk of experiencing serious complications due to COVID-19.

Speaking onthe high HbA1C level in the city and challenges faced by the patients during the lockdown, Dr. Sailesh Lodha, HOD & Sr. Consultant-Diabetes and Endocrinology, Eternal Hospital, said, “People living with diabetes have to be more careful about their health and well-being in the current lockdown due to COVID-19. The risk of developing severe complications is higher in people with diabetes and COVID-19 can lead to more fatalities in people with diabetes. It is recommended that people with diabetes should follow a strict regimen so that their blood glucose levels are in the required range. A part from their medications, people with diabetes should also practice indoor physical exercises to manage diabetes effectively.

Currently, more than 77 million people in India are living with diabetes. To provide them with optimal care and help them in managing their condition better during the lockdown, the Government of India has stated that all known/ diagnosed people with diabetes will receive regular supply of medicines for up to three months through ASHAs (Accredited Social Health Activists) or SHCs (Sub Health Centres) on prescription.

Talking about the IMPACT India programme,Dr. Anil Shinde, Trustee, Novo Nordisk Education Foundation said, “Through the India Diabetes Care index, weaim to raise awareness onstatus of diabetes care in India. The latest findings suggest that the status of diabetes management should be paid close attention to because if diabetes is well-managed, the risk of serious illness from COVID-19 can be reduced tothe same as that in general population. People with diabetes should also take strict preventive measures so that they can minimize the risk from COVID-19 and are safe in the lockdown period.”

People with diabetes should have anadequate stock of medications and supplies for monitoring blood glucose at home. They should store enough stock of simple carbohydrates like honey, jam andcandies. They should also store Glucagon and ketone strips, in case of poor glycaemic control (low or high blood glucose levels). People with diabetes should also watch for emergency warning signs likedifficulty in breathing or shortness of breath, persistent pain or pressure in the chest, confusion or inability to arouse, bluish lips or face. In case they develop or suspect to have COVID-19 symptoms, people with diabetes are advised to get medical attention immediately by calling the hospital or personal physician and explaining their condition.

The ‘Impact India: 1000-Day Challenge’ programme was launched in 2018 to address the issue of sub optimally controlled diabetes in India. The ambition of the programme is to reduce the national average of HbA1c by 1%, which can help reduce the risk of diabetes-related complications significantly in India.  Based on big data analytics, iDCI® has been providing a real-time view of the average HbA1c in India across select cities. Under the Impact India programme, digital platforms are being leveraged to partner with healthcare practitioners (doctors and paramedics) to evolve and implement an approach to diabetes care appropriate for India. iDCI® is a dynamic tool that not only tracks the status of diabetes care but also helps to increase awareness, motivate and sensitize the healthcare professionals (HCPs) and society.The IMPACT India programme will continue its three-pronged approachthrough interactions with healthcare practitioners (HCPs), societal/patient engagement and monitoring.