Revised ACP Guidelines on HBA1C Herald Trouble For Indian Diabetics

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Diabetes has been a nightmare for most Indians and often heralds a slew of complications for its patients. The chronic nature of Diabetes Mellitus necessitates lifelong medication and appropriate management of blood sugar levels.

While the Indian specialists have always adhered to strict control parameters to keep the disease in check (HBA1C reading below 7), a recent published report of The American College of Physicians have recommendated new guidelines recommending that diabetologists should aim to achieve HBA1C between 7% to 8% in patients with type 2 diabetes.

This has in turn resulted in patients questioning the line of treatment all this while. There are apparently several cases of patients who have based on this, reduced their medication doses, leading to unprecedented high blood sugar levels.

Pune365 spoke to eminent Diabetologists and affected patients to ascertain the ideal course of treatment, in the best interest of our readers. 

Dr Chandra Kath, Diabetologist Rao says,” Strict glucose control ( HbA1c below 7 %) has been proved to prevent long-term complications of diabetes like eye retinopathy, kidney failures and nerve damage leading to ulcers.

Most studies are in favour of strict glucose control to be maintained, hence the specialists treatment is driven to achieve these goals. The new ACP guidelines suggesting a less stringent glucose control goes against the established guidelines based on years of dedicated research.

The consequences of this in the Indian setup may turn problematic as it poses a dilemma in the patient’s minds on the right line of treatment.

Indian doctors see a lot of patients as we have amongst the highest incidences of diabetes in the world. Indian patients tend to develop diabetes at least a decade earlier and also tend to suffer more complications than the western population.

Also diabetes is a silent threat for most of the patients. Hence it is important to manage diabetes strictly with the aim to prevent complications. I support the Indian doctors who oppose the ACP guidelines.

Already there is a lot of confusion in our patient’s minds. Some patients have reduced medication dosages on their own resulting in uncontrolled blood sugar levels.. A sense of complacency has set in and that can lead to future health problems for the patient.

 Ikrar Mohammed Shiekh, Analytical Chemist and a patient of Diabetes Mellitus, affirms, “ACP is a reputed worldwide organization and if they publish a report, it is obviously based on proper research and study.

It would certainly benefit those diabetics who management their blood sugar levels well.

In India, many healthcare professionals and pharmaceutical companies are focussed on the business of it all. It’s a huge industry with high profit margins.

The Government in my opinion should go public with the right methodology and spread awareness of this on an urgent basis so that diabetics can benefit from the same.

Dr.Reema Kashiva, Diabetologist does not see merit with with these new guidelines and says, “For one to follow new guidelines, there should be some established case studies that reinforce the fact that there will be no future complications .

Only then, can we be sure of this being a sensible option.”

I agree with my Indian colleagues, and truly believe that effective treatment, is more than just control of blood sugar levels, and we must prevent complications arising out of diabetes in future. Also, a diabetes patient trust his doctor more than any guideline.

There should be no confusion in diabetes patients and they must undoubtedly, follow their doctors advise.

Dr.R.P Garg, Diabetologist, opines, “The HBA1C should be below 7%. There are no changes in the Diagnostical criteria of the diabetic patients.

I do not subscribe to these new guidelines as, if the reading is more then 7 then it can lead to cardiovascular diseases among other complications.

The specialist’s goal is keep the levels with a reading of 7, and that is the right approach to avoid future complications for the patient.

I think the ACP is right in its decision to change the readings. All this different diet reasons being talked about here is all nonsense.

The plain fact is that most doctors favour  pharmaceutical companies, and these companies will lose a lot of business by this move opines James Albuke, a patient of Diabetes Mellitus 

These companies are only concerned about the money. Why hasn’t there been a cure for diabetes or cancer despite all this research and skill.

I hail the ACP decision and it has changed my perception of my condition. Humanitarian values have taken the back seat in the quest for money.”


#All views expressed in this article are those of the individual respondents and Pune365 does not necessarily subscribe to them.

Riya Kalwani

Riya Kalwani

Poetess, Dreamer, Free soul and a writer who is living to write her story in a better way. Dogs and cheese makes me happy.
Riya Kalwani