An Observational Study of the Physical and Biochemical Complications and Socioeconomic Status of Type 1 Diabetic Patients in West Bengal, India: A 25-year Follow-up Report of 224 Patients

Background: Limited information is available on the total profile of type 1 diabetes mellitus patients in India. The present study has been undertaken, therefore, in search of socioeconomic status, glycaemic status and the state of complications of the type 1 diabetics attending the diabetic clinic run by Calcutta Diabetes and Endocrine Foundation (CDEF), Kolkata.

Objectives: (1) To obtain the glycemic, socioeconomic, and complications status of type 1 diabetic patients; (2) to see any change of the abovementioned parameters in this follow-up period of 25 years; (3) to take necessary action to improve the quality of care and the health condition of the type 1 diabetics attending the clinic.

Study design and setting: A longitudinal observational study. A total of 265 patients were recruited for the study, having been diagnosed or seen within 1 year of diagnosis of type 1 diabetes at the Diabetic Clinic of CDEF. A total of 41 patients were excluded from the study for different reasons, and 224 patients were finally selected. These 224 patients were classified into five separate cohorts according to their first attendance in the diabetes clinic: 1996-2000 (I), 2001-2005 (II), 2006-2010 (III), 2011-2015 (IV), and 2016-2020 (V). Baseline and socioeconomic (based on education and occupational status) data was obtained at the first visit, and mean biochemical parameters were taken from multiple visits. Complications and mortality rates were calculated against the duration of the disease at the end of the study.

Results: Gradual improvement of glycemic status was noted when groups I and V were compared. Delayed development of complications and comparatively long life were also observed.

Conclusion: Several methods of improvement of clinical disease management, including continuous diabetes education with proper training, can improve diabetes care, leading to delays in the development of diabetic complications and ensuring longer as well as healthier life in type 1 diabetes. The development of socioeconomic status might have played some role.