1363-P: Diabetes Control and Complications in West India—Three-Year Results of LANDMARC Trial

• Published in: Diabetes (New York, N.Y.) Vol. 73; no. Supplement_1; p. 1
• Main Authors: JOSHI, SHASHANK R., SETHI, BIPIN, GOPALAKRISHNAN UNNIKRISHNAN, AMBIKA, CHAWLA, MANOJ S., PATANGE, SONALI A., SHAH, TEJAS, JOSHI, AMEYA S., GOKALANI, RUTUL, GANDHI, PRAMOD D., MENON, SHALINI K., GADEKAR, ARVIND, CHODANKAR, DEEPA
• Format: Journal Article
• Language: English
• Published: New York American Diabetes Association 14.06.2024
• Subjects: Blood glucose; Diabetes; Diabetes mellitus; Diabetic neuropathy; Disease management; Dyslipidemia; Insulin; Microvasculature; Myocardial infarction; Neuropathy; Risk factors; Trends; India
• ISSN: 0012-1797; 1939-327X
• DOI: 10.2337/db24-1363-P

Glycemic control, therapy trends, and diabetes complications were evaluated in LANDMARC — a prospective observational 3-year study (CTRI/2017/05/008452) of participants with T2D on ≥2 antihyperglycemic medications. This sub-analysis of 81 sites in West India (Ahmedabad, Mumbai, and Pune) included 1351 participants (mean [SD] baseline [BL] age: 53.2 [9.1] years, T2D duration: 8.9 [5.8] years and A1C: 7.9% [1.5]). At BL, most were insulin-naïve (n=1037; 77.4%), mainly on OADs (n=1013; 76.9%). At 3 years, 68.2% (n=733) were on OADs only, while 29.8% (n=320) were on insulin + OADs. Biguanides was the most prescribed class (BL: 1253 [93.5%] and 3-years: 1007 [93.7%]). Basal insulin usage increased from BL (n=203; 15.2%) to 3 years (n=237; 22.1%). Mean (SD) A1C, FPG, and PPG decreased by 0.4 (1.5) %, 7.2 (48.2) mg/dL, and 16.5 (73.8) mg/dL, respectively; and an increase in proportion of participants with A1C<7% (BL: 257/920 [27.9%]; 3 years: 250/940 [34.4%]), was noted. Myocardial infarction and neuropathy were the most common macro and microvascular complications, respectively (Table). Hypertension and dyslipidemia were most common CV risk factors. West India had the highest proportion of participants with CV risk factors. An understanding of pivotal regional trends in glycemia, therapy, and complications may help strategize future diabetes management practices in India.