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ACP Recommendations of HBA1C between 7%-8% NOT APPLICABLE to Indian Diabetics- Dr Shashank Joshi

ACP Recommendations of HBA1C between 7%-8% NOT APPLICABLE to Indian Diabetics- Dr Shashank Joshi

An HbA1C test measures a person’s average blood sugar level over the past two or three months. Generally An HbA1C of 6.5 percent indicates diabetes.

However, according to new recommendations of American College of Physicians (ACP) there is no proof of benefit for targets of HbA1c below 7%. Therefore, in an evidence-based guidance statement, ACP has suggested that HbA1c between 7%  & 8%  was okay for most T2 DM patients. This implies that most patients with type 2 diabetes should be treated to achieve an A1C between 7 percent and 8 percent rather than 6.5 percent to 7 percent published todayThe updated guidance has been published online in Annals of Internal Medicine

Read ALso: HbA1c between 7% and 8% okay for T2DM Patients-New ACP Guidelines

Refuting the guidelines in the Indian Perspective, Dr Shashank R Joshi leading Endocrinologist in Mumbai and Member Editorial Board, Diabetology at Specialty Medical Dialogues, stated that these guidelines do not apply in the Indian context

 “The current ACP guidance for Type 2 diabetes don’t apply to the Indian population.Indians have our own ICMR, RSSDI and API recommendations.also, Indians have different phenotype, genotype as well as lifestyle issues.For Asian Indian, we need to transcultural our own recommendations based on our food and activity. Also, we have now our own Indian evidence base.This guidance now creates confusion in the USA because expert bodies like ADA and AACE have glycosylated Hb at 7 and 6.5 while ACP which is an internist body speaks about 7 to 8. What we need to learn from ACP recommendations is the need to individualize and personalized diabetes care,” stated Dr Shashank Joshi,
He added that the guidelines are now adding to the confusion for the Indian medical practitioners at large. “ACP in an attempt to simply for generalist or internist have attempted to create confusion between experts and generalists. Moreover,  it will lead to confusion with doctors and patients when they see conflicting views.Fortunately, in India, we don’t have such confusion and we should never follow us recommendation because they are meant for their race and geography, not outs.Indians Chinese as well as Asians eat more carbohydrates and therefore both doses to responses of our population to medicines is different.” he added
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  1. user
    Dr Sanjay Talgaonkar April 4, 2018, 9:38 pm

    दूष्यं देशं बलं कालं अनलं प्रकृतिं वयः।
    सत्वं सात्म्यं तथाऽहारमवस्थाश्च पृथग्विधाः।।
    सूक्ष्मसूक्ष्माः समीक्षैषां दोषौषधनिरूपणे।
    यो वर्तते चिकित्सायां न स स्खलति जातुचित् ।। अ.हॄ.सू.12/66,67
    In Ayurveda, our ancient science, it has been stated that the clinician who treats the patient after a minute analysis of body composition (दूष्यं), geographical location (देशं), strength / immunity (बलं), season ( कालं), digestive ability (अनलं),nature of the body (प्रकृतिं), age (वयः), attributes (सत्वं), acceptance of body/ substances conducive to the person (सात्म्यं) and diet (आहार) is ever successful.

  2. Agree .we cant keep so lose control it is indians do not follow strict diets and hardly do any exercise more prone for DM complications a decade early . With no much insurance cover

  3. user
    Dr. Vishnu Mulchandani April 2, 2018, 5:18 pm

    We, Indians have more of carbohydrates, more of visceral fat, have more complications because Diabetes patients come late to us as they have to pay from their own pocket
    Hence ideally HbA1c should be less than 7 %

  4. See our diet pattern, work pattern and lifestyle differs a lot from western world,so we shouldn\’t blindly follow ADA.

  5. user
    Solanki Sahebrao March 30, 2018, 10:43 pm

    According to geographic location,dietary habbits and Indians BMI,we should not follow the western recommendation to treat tpye2 Diab.We indians are suitable to treat at 7-8 HBA1c level.