In India, medical practitioners feel the guidelines will lead to serious complications and also confusion in the treatment protocol for diabetic patients.
‘Medical practitioners in India feel the guidelines lead to serious diabetic complications & confusion in the treatment protocol.’
In 2017, over 72 million cases of diabetes were recorded in India, according to International Diabetes Federation.
The new guidelines relating to relaxing the long-term blood sugar target, hemoglobin A1C (HbA1c), which through a blood test gives an estimate of the individual's blood sugar level average over the past few months. An HbA1c of 6.5 percent indicates diabetes.
American College of Physicians, an organization of internal medicine physicians, recommended recently in the medical journal Annals of Internal Medicine.
Clinicians need to aim for an HbA1c level between 7 percent and 8 percent in most patients with type 2 diabetes, as against the traditional 6.5 to 7 percent.
The recommendation is leading to a conflict of views amongst doctors and physicians, and also few associations are opposing it.
Doctors say that the guideline of decreasing the blood sugar should be ignored, as diabetes in India is more aggressive, and hence riddled with complications.
They also say that these recommendations should not be applicable, as India has its guidelines as recommended by three bodies such as ICMR (Indian Council of Medical Research), RSDDI (Research Society For The Study of Diabetes in India) and API (Association of Physicians of India), which are more attuned to the Indian diabetic population.
Anoop Misra chairman of Delhi-based Fortis-C-DOC (Centre of Excellence For Diabetes, Metabolic Diseases and Endocrinology) said, "In reality, Indian physicians continue to follow US-based guidelines. Hence ACP uidelines may have a substantial impact in India. If blood sugar control is loosened (as advised by ACP), more patients in India will suffer from complications, the burden of which is already high. We should ignore these, and stick to previous time-tested glycosylated hemoglobin limit of control of 7 percent".
Others agree that these guidelines cannot be standardized due to differences in lifestyle, physiology and food habits.