The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial)
Abstract Introduction LANDMARC (CTRI/2017/05/008452), a prospective, observational real‐world study, evaluated the occurrence of diabetes complications, glycemic control and treatment patterns in people with type 2 diabetes mellitus (T2DM) from pan‐India regions over a period of 3 years. Methods Par...
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| Format: | Article |
| Language: | English |
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Wiley
2023-09-01
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| Series: | Endocrinology, Diabetes & Metabolism |
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| Online Access: | https://doi.org/10.1002/edm2.422 |
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| author | Ashok K. Das Sanjay Kalra Shashank Joshi Ambrish Mithal K. M. Prasanna Kumar A. G. Unnikrishnan Hemant Thacker Bipin Sethi Subhankar Chowdhury Amarnath Sugumaran Ashwini Satpathy Arvind Gadekar Shalini K. Menon Renuka Neogi Deepa Chodankar Chirag Trivedi S. K. Wangnoo A. H. Zargar Nadeem Rais LANDMARC study group |
| author_facet | Ashok K. Das Sanjay Kalra Shashank Joshi Ambrish Mithal K. M. Prasanna Kumar A. G. Unnikrishnan Hemant Thacker Bipin Sethi Subhankar Chowdhury Amarnath Sugumaran Ashwini Satpathy Arvind Gadekar Shalini K. Menon Renuka Neogi Deepa Chodankar Chirag Trivedi S. K. Wangnoo A. H. Zargar Nadeem Rais LANDMARC study group |
| author_sort | Ashok K. Das |
| collection | DOAJ |
| description | Abstract Introduction LANDMARC (CTRI/2017/05/008452), a prospective, observational real‐world study, evaluated the occurrence of diabetes complications, glycemic control and treatment patterns in people with type 2 diabetes mellitus (T2DM) from pan‐India regions over a period of 3 years. Methods Participants with T2DM (≥25 to ≤60 years old at diagnosis, diabetes duration ≥2 years at the time of enrollment, with/without glycemic control and on ≥2 antidiabetic therapies) were included. The proportion of participants with macrovascular and microvascular complications, glycemic control and time to treatment adaptation over 36 months were assessed. Results Of the 6234 participants enrolled, 5273 completed 3 years follow‐up. At the end of 3‐years, 205 (3.3%) and 1121 (18.0%) participants reported macrovascular and microvascular complications, respectively. Nonfatal myocardial infarction (40.0%) and neuropathy (82.0%) were the most common complications. At baseline and 3‐years, 25.1% (1119/4466) and 36.6% (1356/3700) of participants had HbA1c <7%, respectively. At 3‐years, population with macrovascular and microvascular complications had higher proportion of participants with uncontrolled glycemia (78.2% [79/101] and 70.3% [463/659], respectively) than those without complications (61.6% [1839/2985]). Over 3‐years, majority (67.7%–73.9%) of the participants were taking only OADs (biguanides [92.2%], sulfonylureas [77.2%] and DPP‐IV inhibitors [62.4%]). Addition of insulin was preferred in participants who were only on OADs at baseline, and insulin use gradually increased from 25.5% to 36.7% at the end of 3 years. Conclusion These 3‐year trends highlight the burden of uncontrolled glycemia and cumulative diabetes‐related complications, emphasizing the importance of optimizing diabetes management in India. |
| first_indexed | 2024-03-12T01:31:10Z |
| format | Article |
| id | doaj.art-57997eb5dcc94d18a610e0249ced28fc |
| institution | Directory Open Access Journal |
| issn | 2398-9238 |
| language | English |
| last_indexed | 2024-03-12T01:31:10Z |
| publishDate | 2023-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism |
| spelling | doaj.art-57997eb5dcc94d18a610e0249ced28fc2023-09-12T04:11:08ZengWileyEndocrinology, Diabetes & Metabolism2398-92382023-09-0165n/an/a10.1002/edm2.422The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial)Ashok K. Das0Sanjay Kalra1Shashank Joshi2Ambrish Mithal3K. M. Prasanna Kumar4A. G. Unnikrishnan5Hemant Thacker6Bipin Sethi7Subhankar Chowdhury8Amarnath Sugumaran9Ashwini Satpathy10Arvind Gadekar11Shalini K. Menon12Renuka Neogi13Deepa Chodankar14Chirag Trivedi15S. K. Wangnoo16A. H. Zargar17Nadeem Rais18LANDMARC study groupMahatma Gandhi Medical College and Research Institute Sri Balaji Vidyapeet Puducherry IndiaBharti Hospital Karnal IndiaLilavati Hospital Mumbai IndiaMedanta‐ The Medicity Gurgaon IndiaCentre for Diabetes and Endocrine Care Bengaluru IndiaChellaram Diabetes Institute Pune IndiaBhatia Hospital Mumbai IndiaCare Hospital Hyderabad IndiaIPGME and R and SSKM Hospital Kolkata IndiaSanofi Mumbai IndiaSanofi Mumbai IndiaSanofi Mumbai IndiaSanofi Mumbai IndiaSanofi Mumbai IndiaSanofi Mumbai IndiaSanofi Mumbai IndiaApollo Hospital Education and Research Foundation New Delhi IndiaCenter for Diabetes & Endocrine Care Srinagar IndiaChowpatti Medical Centre Mumbai IndiaAbstract Introduction LANDMARC (CTRI/2017/05/008452), a prospective, observational real‐world study, evaluated the occurrence of diabetes complications, glycemic control and treatment patterns in people with type 2 diabetes mellitus (T2DM) from pan‐India regions over a period of 3 years. Methods Participants with T2DM (≥25 to ≤60 years old at diagnosis, diabetes duration ≥2 years at the time of enrollment, with/without glycemic control and on ≥2 antidiabetic therapies) were included. The proportion of participants with macrovascular and microvascular complications, glycemic control and time to treatment adaptation over 36 months were assessed. Results Of the 6234 participants enrolled, 5273 completed 3 years follow‐up. At the end of 3‐years, 205 (3.3%) and 1121 (18.0%) participants reported macrovascular and microvascular complications, respectively. Nonfatal myocardial infarction (40.0%) and neuropathy (82.0%) were the most common complications. At baseline and 3‐years, 25.1% (1119/4466) and 36.6% (1356/3700) of participants had HbA1c <7%, respectively. At 3‐years, population with macrovascular and microvascular complications had higher proportion of participants with uncontrolled glycemia (78.2% [79/101] and 70.3% [463/659], respectively) than those without complications (61.6% [1839/2985]). Over 3‐years, majority (67.7%–73.9%) of the participants were taking only OADs (biguanides [92.2%], sulfonylureas [77.2%] and DPP‐IV inhibitors [62.4%]). Addition of insulin was preferred in participants who were only on OADs at baseline, and insulin use gradually increased from 25.5% to 36.7% at the end of 3 years. Conclusion These 3‐year trends highlight the burden of uncontrolled glycemia and cumulative diabetes‐related complications, emphasizing the importance of optimizing diabetes management in India.https://doi.org/10.1002/edm2.422diabetes‐related complicationsglycemic controlIndiaLANDMARCreal‐world evidenceT2DM |
| spellingShingle | Ashok K. Das Sanjay Kalra Shashank Joshi Ambrish Mithal K. M. Prasanna Kumar A. G. Unnikrishnan Hemant Thacker Bipin Sethi Subhankar Chowdhury Amarnath Sugumaran Ashwini Satpathy Arvind Gadekar Shalini K. Menon Renuka Neogi Deepa Chodankar Chirag Trivedi S. K. Wangnoo A. H. Zargar Nadeem Rais LANDMARC study group The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial) Endocrinology, Diabetes & Metabolism diabetes‐related complications glycemic control India LANDMARC real‐world evidence T2DM |
| title | The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial) |
| title_full | The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial) |
| title_fullStr | The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial) |
| title_full_unstemmed | The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial) |
| title_short | The LongitudinAl Nationwide stuDy on Management And Real‐world outComes of diabetes in India over 3 years (LANDMARC trial) |
| title_sort | longitudinal nationwide study on management and real world outcomes of diabetes in india over 3 years landmarc trial |
| topic | diabetes‐related complications glycemic control India LANDMARC real‐world evidence T2DM |
| url | https://doi.org/10.1002/edm2.422 |
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