Treatment and control of diabetes in India: A systematic review and meta-analysis

Background: Diabetes is a major contributor to hospital admissions, out-of-pocket expenditure, and premature mortality in India. Proper treatment and adequate control rates are needed to reduce the complications and deaths due to diabetes. Hence, we conducted a systematic review and meta-analysis of community-based studies to estimate the treatment and control rate of diabetes among adults in India. Methods: A systematic electronic search was conducted in PubMed, Embase, Cochrane Library, and Google Scholar to retrieve community-based studies which reported the prevalence of treatment and control of diabetes among adults in India, without any date or language restriction. To estimate the pooled prevalence and heterogeneity, the random-effects model and I2 statistic methods were employed. We did subgroup analyses based on study setting and type of blood test. Results: We included seven studies in this meta-analysis, which comprised a total of 9,033 participants. The pooled prevalence of treatment and control of diabetes among adults in India was 75.9% (95% confidence interval [CI]: 63.8%–86.2%) and 56.4% (95% CI: 44.7%–67.9%), respectively. There was significant heterogeneity between the studies (P < 0.001). The subgroup analysis based on the study setting revealed a decrease in heterogeneity among the urban studies for the control of diabetes. Conclusions: Three-fourths of the diagnosed (self-reported) diabetic patients were on treatment. Of these, half of the patients had adequate glycemic control. Targeted actions need to focus on the determinants of adherence to medication and follow-up.