Low-cost care models directed at patients — reminders, guideline prompts and culture of quality — can help improve adherence, risk factor control, patient satisfaction and help diabetics double the likelihood of controlling the disease.

Led by leading researchers at the Public Health Foundation of India, All India Institute of Medical Sciences and United States-based Emory University, a new trial at 10 clinical centres in India and Pakistan has shown that medicines alone cannot be used to control escalating health costs and poor quality of life due to diabetes.

The study is the first trial of comprehensive diabetes management in a low/middle-income country setting. 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.

No expensive drugs

“This intervention doesn’t require new or expensive drugs. Instead, it enhances patients’ likelihood of managing their disease on their own by providing individualised support and enhancing the physician’s likelihood of being responsive,” noted the study.

The results show that interventions yielded sizeable improvements in blood sugar, blood pressure and cholesterol profiles of participants using this low-cost approach.

According to the study, better control of blood sugar, blood pressure and cholesterol levels offers hope to diabetics of reducing the onset of related complications like heart disease, eye disease, kidney failure and amputations, which are very common in people with diabetes in South Asia. The benefits were similar in public and private diabetes clinics, which shows that health inequalities can be reduced with structured care.

These findings are relevant for the U.S., India, Pakistan and many other countries, including low-middle-and-high-income countries, where achievement of diabetes care goals is suboptimal and health disparities are common.

The collaborative study, funded by the U.S.-based National Institutes of Health, shows the value that can be gained from global collaborations in research to imsprove health. Next steps involve a continued follow-up of this study to evaluate whether this approach reduces diabetes complications like heart attacks, strokes, eye diseases, kidney failure, and amputations in the long term and to assess patients’ and providers’ views so that intervention can be delivered more widely.
Trial shows low-cost care model can help diabetics double the chances of controlling the disease