The latest findings of India Diabetes Care Index (IDCI) suggest that glycosylated hemoglobin or HbA1c level recorded at 8.35% during January to March 2020 and it marginally decreased from 8.47% to 8.35% as compared to the previous quarter in New Delhi. The high level of HbA1C level in Delhi 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 New Delhi had an average age of 53 years out of which 56% were male and 44% were female.

Furthermore, the average postprandial glucose level in the quarter was 235 mg/dl and the average fasting glucose level was 167 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.

Talking about the IMPACT India programme, Dr. Anil Shinde, Trustee, Novo Nordisk Education Foundation said, “Through the India Diabetes Care index, we aim to raise awareness on status 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 to the 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.”

Speaking on the high HbA1C level in Delhi and challenges faced by the patients during the lockdown, Dr Ambrish Mithal, Chairman, Endocrinology and Diabetes, Max Healthcare, said, “It is a good indicator that the HbA1c level in New Delhi has remained stable or even declined marginally in the last quarter. However, it is still clearly above desired levels, and, people with diabetes should observe all precautions as they are at a higher risk of developing complications from COVID-19. To protect themselves, people should follow a healthy diet, ensure indoor physical activity, and test their blood glucose regularly. They should also remain in touch with their doctor through mail or video consulting.”

In Mumbai, IDCI suggest that glycosylated hemoglobin or HbA1c level increased from 8.19% to 8.22% during January to March 2020 as compared to the previous quarter in Mumbaikars.

People who were part of the assessment in Mumbai had an average age of 53 years, out of which 55% were male and 45% were female. Furthermore, the average postprandial glucose level was 227 mg/dl in the quarter and the corresponding average fasting glucose level was 162 mg/dl.

Speaking on the high HbA1C level in the city and challenges faced by the patients during the lockdown, Dr. Rajiv Kovil, Consultant Diabetologist, Mumbai, said, “People living with diabetes have to be particularly vigilant about their health and well-being in the present lockdown due to COVID-19. Not only are they at a greater risk of developing severe complications but COVID-19 can also lead to more fatalities in people with diabetes. A thorough health regime must be followed so that blood glucose levels are kept in check. In addition to the medications, under the given situation, it is advisable to follow indoor physical exercises in order 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.