IMPACT India: A novel approach for optimum diabetes care

Abstract

India has the second largest population with diabetes mellitus in the world. Long-term, uncontrolled diabetes is associated with increased microvascular and macrovascular (commonly cardiovascular) complications and death. The large burden of uncontrolled diabetes in India could be because of lack of treatment adherence, limited access to laboratory testing, lack of physical activity, and poor dietary habits. This creates a compelling need for a greater involvement of healthcare professionals (HCPs) in improving societal awareness and regular monitoring of glycemic control, which is limited in patient outreach programs. IMPACT India, launched in November 2018, is a diabetes control program with a three-pronged approach aimed at creating an impact at the level of HCPs, society, and individuals living with diabetes. The India Diabetes Care Index (iDCI®), a quarterly aggregate index of glycated hemoglobin, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG), forms the backbone of IMPACT India. The program uses iDCI® to evaluate glycemic control at periodic intervals, sensitize HCPs about the glycemic control status, and optimize diabetes care by escalating pharmacotherapy including insulin whenever required. Societal awareness will be created by social media to achieve actionable awareness based on the iDCI® reports. At baseline (January 2018 to June 2018), the database (2.39 million) revealed an average glycated hemoglobin of 8.56%, FPG of 172 mg/dL, and PPG of 253 mg/dL. Also, 74% of the patients had HbA1c >7% and FPG >130 mg/dL and >83% of the patients had PPG >160 mg/dL. The IMPACT India program aims to positively impact diabetes care in India by achieving at least 1% glycated hemoglobin reduction in 1000 days