Sunday 16 December, 2018
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New Emory-led model promises diabetics low-cost control on the disease

Mohammad K. Ali,associate professor at Emory’s Rollins School of Public Health.

NRI Pulse Staff Report

Atlanta, GA, July 13: Researchers at Emory University’s Rollins School of Public Health along with the Public Health Foundation of India, and the All India Institute of Medical Sciences (AIIMS) found that a low-cost care, intervention model can help patients with diabetes double their likelihood of controlling the disease.

Published in the July 12th edition of Annals of Internal Medicine, researchers analyzed results from a new trial conducted at ten clinical centers throughout India and Pakistan to compare the effect of a multicomponent, diabetes-focused quality improvement strategy versus the usual care alternatives for heart patients with poorly controlled diabetes.

Led by Mohammad K. Ali, MBChB, MSc, associate professor at Emory’s Rollins School of Public Health, the team compared the effects of multicomponent diabetes QI strategy versus usual care in South Asia, where resources are limited and diabetes is prevalent. Approximately 1,150 patients with diabetes and poor cardiometabolic profiles were randomly assigned to a multicomponent QI strategy or usual care for two and a half years. Results suggested that patients in the QI strategy group were twice as likely to achieve combined diabetes care goals and larger reductions for each risk factor compared with usual care.

“This was the first trial of comprehensive diabetes management in a low/middle-income country setting,” explained Ali.  “This intervention doesn’t require new or expensive drugs, but instead it enhances a patient’s likelihood of managing their disease on their own by providing individualized support and enhancing the physician’s likelihood of being responsive.”

Finding from the trial also showed that the new intervention yielded sizeable improvements in the blood sugar, blood pressure, and cholesterol profiles of participants. Benefits were similar in public and private diabetes clinics indicating that, with structured care, health inequalities can possibly be reduced

Dr. K.M.Venkat Narayan, director of Emory Global Diabetes Research Center.

“By better controlling their blood sugar, blood pressure, and cholesterol levels, our study offers a hope of reducing onset of diabetes complications like heart disease, eye disease, kidney failure, and amputations which are very common in people with diabetes in South Asia,” said Ali. “Since these findings are relevant for the US, India, Pakistan, and many other countries, low-, middle-, and high-income countries alike, further research will uncover whether this approach reduces diabetes complications such heart attacks, strokes, eye disease, kidney failure, and amputations in the long-term and to assess patients’ and providers’ views so that the intervention can be delivered more widely.”

“These data show that it is possible to effectively deliver high quality diabetes care at low-cost in places like India and Pakistan, and these findings now need  to be translated  into practice and policy for millions of people  with diabetes  in the sub-continent through policy initiatives,” said Dr. K.M.Venkat Narayan, director of Emory Global Diabetes Research Center and professor of epidemiology and medicine at Emory University.   “We are also excited about how Emory University’s collaborations with India and Pakistan is helping generate the highest quality science to directly impact the health of people in those countries, something that should  make the Indian-American and Pakistani-American community so proud – as a way of giving back to their motherlands.”

Of the 415 million people with diabetes worldwide, 75 per cent live in low/middle-income countries. India alone is home to the second highest number of people with diabetes [nearly 70 million] worldwide.

Nikhil Tandon, Professor and Head, Department of Endocrinology, AIIMS, said: “Approximately 1,150 patients with diabetes and poor cardio metabolic profiles were randomly assigned to a multi-component QI strategy or usual care for two and a half years. Results suggested that patients in the QI strategy group were twice as likely to achieve combined diabetes care goals and larger reductions for each risk factor compared with usual care.”

“This was the first trial of comprehensive diabetes management in a low and middle-income country setting,” explained Tandon adding that the intervention doesn’t require new or expensive drugs, but instead it enhances a patient’s likelihood of managing their health condition on their own by providing individualized support.

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