Endocrinology, Diabetes & Metabolism (Jul 2021)

Baseline characteristics of participants in the LANDMARC trial: A 3‐year, pan‐india, prospective, longitudinal study to assess management and real‐world outcomes of diabetes mellitus

  • Ashok K. Das,
  • Ambrish Mithal,
  • Shashank Joshi,
  • K. M. Prasanna Kumar,
  • Sanjay Kalra,
  • A. G. Unnikrishnan,
  • Hemant Thacker,
  • Bipin Sethi,
  • Romik Ghosh,
  • Vaishali Kanade,
  • Arjun Nair,
  • Senthilnathan Mohanasundaram,
  • Shalini K. Menon,
  • Deepa Chodankar,
  • Vaibhav Salvi,
  • Chirag Trivedi,
  • Godhuli Chatterjee,
  • Subhankar Chowdhury,
  • Nadeem Rais,
  • Subhash K. Wangnoo,
  • Abdul H. Zargar

DOI
https://doi.org/10.1002/edm2.231
Journal volume & issue
Vol. 4, no. 3
pp. n/a – n/a

Abstract

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Abstract Introduction Longitudinal data on progression, complications, and management of type 2 diabetes mellitus (T2DM) across India are scarce. LANDMARC (CTRI/2017/05/008452), the first pan‐India, longitudinal, prospective, observational study, aims to understand the management and real‐world outcomes of T2DM over 3 years. Methods Adults (≥25 to ≤60 years old at T2DM diagnosis; diabetes duration ≥2 years at enrollment; controlled/uncontrolled on ≥2 anti‐diabetic agents) were enrolled. Baseline characteristics were analyzed using descriptive statistics. Results Of the 6279 recruited participants, 6236 were eligible for baseline assessment (56.6% [n/N = 3528/6236] men; mean ± SD age: 52.1 ± 9.2 years, diabetes duration: 8.6 ± 5.6 years). mean ± SD HbA1c, fasting plasma glucose, and postprandial glucose values were 64 ± 17 mmol/mol (8.1 ± 1.6%), 142.8 ± 50.4 mg/dl, and 205.7 ± 72.3 mg/dl, respectively. Only 25.1% (n/N = 1122/6236) participants had controlled glycemia (HbA1c < 53 mmol/mol, <7%). Macrovascular and microvascular complications were prevalent in 2.3% (n/N = 145/6236) and 14.5% (n/N = 902/6236) participants, respectively. Among those with complications, non‐fatal myocardial infarction (n/N = 74/145, 51.0%) and neuropathy (n/N = 737/902, 81.7%) were the most reported macrovascular and microvascular complication, respectively. Hypertension (n/N = 2566/3281, 78.2%) and dyslipidemia (n/N = 1635/3281, 49.8%) were the most reported cardiovascular risks. Majority (74.5%; n/N = 4643/6236) were taking oral anti‐diabetic drugs (OADs) only, while 24.4% (n/N = 1522/6236) participants were taking OADs+insulin. Biguanides (n/N = 5796/6236, 92.9%) and sulfonylureas (n/N = 4757/6236, 76.3%) were the most reported OADs. Basal (n/N = 837/6236, 13.4%) and premix (n/N = 684/6236, 11.0%) insulins were the most reported insulins. Conclusions Baseline data from LANDMARC help understand the clinical/medical profile of study participants and underscore the extent of suboptimal glycemic control and prevalence of associated complications in a vast majority of Indians with T2DM.

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