Introduction and Objective: There is limited evidence about management of multimorbidity among those with diabetes in India.Methods: We conducted a large population representative cross-sectional survey in North and South India (both rural and urban) using multistage cluster random sampling among 12284 adults aged ≥ 30 years. Trained interviewers administered a questionnaire to collect data on socio-demographics, lifestyle characteristics and collected fasting blood samples. Diabetes mellitus was defined per standard definition. Diabetes related multimorbidity (DRM) was defined as diabetes plus ≥ one of the following – hypertension, dyslipidemia, depression, heart disease, stroke and chronic kidney disease. Management was assessed per ADA guidelines.Results: The mean (SD) age of participants was 49.2 (12.6) years and 53% were women. Diabetes prevalence was 17.9% (17.2-18.6). Most people with diabetes [94% (92.9-94.9)] had DRM, with sub-optimal management as indicated by: mean HbA1c [7.6 (1.9)], systolic BP [135.1 (19.7)], diastolic BP [81.6 (10.7)], LDL [116.5 (39.1)], HDL [38.5 (10.1)], total cholesterol [188.9 (45.3)]. Further, only 28.3% (95% CI: 26.4-30.3) of those with DRM had their blood pressure controlled, 47.1% (44.9-49.3) had glucose controlled, and just 1.7% (1.2-2.4) had lipid levels controlled, per ADA guidelines.Conclusion: Management of multimorbidity is sub-optimal in India. Health system level integrated interventions focused on cardiometabolic risks are warranted to improve management and patient outcomes.
S. Mohan: None. M. Shenoy: None. N. Srinivasapura Venkateshmurthy: None. A. Brahmbhatt: None. R. Bhagat: None. R. Khatkar: None. D. Prabhakaran: None.
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