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Glycemic control, therapy trends, and diabetes complications were evaluated in LANDMARC — a prospective observational 3-year study (CTRI/2017/05/008452) of participants with T2D on ≥2 antihyperglycemic medications. This sub-analysis of 81 sites in West India (Ahmedabad, Mumbai, and Pune) included 1351 participants (mean SD baseline BL age: 53.2 9.1 years, T2D duration: 8.9 5.8 years and A1C: 7.9% 1.5). At BL, most were insulin-naïve (n=1037; 77.4%), mainly on OADs (n=1013; 76.9%). At 3 years, 68.2% (n=733) were on OADs only, while 29.8% (n=320) were on insulin + OADs. Biguanides was the most prescribed class (BL: 1253 93.5% and 3-years: 1007 93.7%). Basal insulin usage increased from BL (n=203; 15.2%) to 3 years (n=237; 22.1%). Mean (SD) A1C, FPG, and PPG decreased by 0.4 (1.5) %, 7.2 (48.2) mg/dL, and 16.5 (73.8) mg/dL, respectively; and an increase in proportion of participants with A1C7% (BL: 257/920 27.9%; 3 years: 250/940 34.4%), was noted. Myocardial infarction and neuropathy were the most common macro and microvascular complications, respectively (Table). Hypertension and dyslipidemia were most common CV risk factors. West India had the highest proportion of participants with CV risk factors. An understanding of pivotal regional trends in glycemia, therapy, and complications may help strategize future diabetes management practices in India. Disclosure S.R. Joshi: Consultant; Twin Health, Marico, Franco Indian, Zydus Cadila, Glenmark Pharmaceuticals. Other Relationship; Novo Nordisk, Sanofi, MSD, Abbott Nutrition, Abbott, Biocon, Alkem, USV Private Limited, Boehringer-Ingelheim. B. Sethi: Other Relationship; Aventis, Novo Nordisk, Eli Lilly and Company, Boehringer-Ingelheim, Merck Sharp Sanofi. Other Relationship; Novo Nordisk. Speaker's Bureau; AstraZeneca, Boehringer-Ingelheim, Abbott, Intas Pharmaceuticals Ltd. Research Support; Torrent Pharmaceuticals Ltd. M.S. Chawla: Advisory Panel; Novo Nordisk. Speaker's Bureau; Novo Nordisk. Advisory Panel; Biocon. Speaker's Bureau; Biocon. Advisory Panel; Eris Lifesciences Ltd. Speaker's Bureau; Eris Lifesciences Ltd. Advisory Panel; Torrent Pharmaceuticals Ltd. Speaker's Bureau; Torrent Pharmaceuticals Ltd. Advisory Panel; USV Private Limited, Lupin Pharmaceuticals, Inc. S.A. Patange: None. T. Shah: None. A.S. Joshi: None. R. Gokalani: None. P.D. Gandhi: None. S.K. Menon: Employee; Sanofi. A. Gadekar: None. D. Chodankar: Employee; Sanofi. Funding Sanofi
Joshi et al. (Fri,) studied this question.