Diabetes Management in Asia

  • Roopa ShivashankarEmail author
  • Kavita Singh
  • L. R. Aravind
  • Nikhil Tandon


Asia is a diverse continent with the largest number of individuals with diabetes in the world. Most Asian countries belong to the low- and middle-income category and are dealing with double burden of diseases. In these countries either a national framework for diabetes or noncommunicable diseases do not exist or are only partially implemented. While health systems in Asian countries consist of both public and private sector, diabetes is commonly managed in the private health-care setting. Therefore, patients incur huge out-of-pocket expenditure leading to high financial burden and low compliance to medication.

Diabetes occurs at a younger age and lower body mass index in Asians. This, coupled with a low detection rate and inadequate quality of care, contributes to a higher frequency of diabetes complications. Interaction of dynamic factors at both physician (lack of local guidelines, overburdened clinics, and inadequate training in diabetes management) and patient (low levels of education, use of alternative treatment, cultural issues related to diet and physical activity) levels has led to sub-optimal diabetes control.

However, there have been many examples of successful small-scale diabetes care models including physician training, use of patient information system, and task shifting in many Asian countries. Countries such as Bangladesh, India, Malaysia, and Thailand have developed or are in the process of developing or scaling up a national program for diabetes management. Incorporation of successful care models in the national programs may improve diabetes outcomes and reduce complications in Asia.


Asia; Diabetes mellitus; Quality of care; Health systems; Culture; Alternative medicines 




Body mass index


Complementary and alternate medicines


Centre for Cardiometabolic Risk Reduction in South Asia Translation Trial


Diabetes Community Lifestyle Improvement Program


Diabetes mellitus


Diabetes Prevention Program


Dipeptidyl peptidase-4




Foot vibration perception by tuning fork


Foot vascular status by Doppler


Glycated hemoglobin


International Diabetes Federation


International Diabetes Management Practice Study


Indian Diabetes Prevention Program


Impaired glucose tolerance


Indian rupee


Integrated naturopathy and yoga


Joint Asia Diabetes Evaluation Program


Latent autoimmune diabetes in adults


Low-density lipoprotein cholesterol


Low- and middle-income countries


Microalbuminuria Prevalence survey


No information available


Noncommunicable disease


National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke


National Strategic Plan for NCDS


Oral glucose tolerance test


Primary prevention of diabetes mellitus


Quality improvement


Randomized controlled trials


Southeast Asia


Type 1 diabetes mellitus


Type 2 diabetes mellitus


US dollars


World Health Organization


  1. 1.
    Asia. Accessed 23 Mar 2017.
  2. 2.
    Misra A, Tandon N, Ebrahim S, Sattar N, Alam D, Shrivastava U, et al. Diabetes, cardiovascular disease, and chronic kidney disease in South Asia: current status and future directions. BMJ. 2017;357:j1420.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Sharma V, Kumar V. Diabetes in Asia. Lancet. 2010;375(9719):982.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Ramachandran A, Ma RC, Snehalatha C. Diabetes in Asia. Lancet. 2010;375(9712):408–18.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    IDF diabetes atlas. 7th ed. Accessed 15 Mar 2017.
  6. 6.
    Nanditha A, Ma RC, Ramachandran A, Snehalatha C, Chan JC, Chia KS, et al. Diabetes in Asia and the Pacific: implications for the global epidemic. Diabetes Care. 2016;39(3):472–85.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Binns C, Low WY. Diabetes in the Asia Pacific region. Asia Pac J Public Health. 2016;28(6):472–4.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Low LC. The epidemic of type 2 diabetes mellitus in the Asia-Pacific region. Pediatr Diabetes. 2010;11(4):212–5.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Zhu HQ, Yang WY. Prevalence of diabetes in Asia-current status and future. Zhonghua Liu Xing Bing Xue Za Zhi. 2011;32(11):1065–7.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Hayashino Y, Fukuhara S. Diabetes in Asia. Lancet. 2010;375(9719):981–2.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Viswanathan V, Sathyamurthy S. Global increase in the prevalence of diabetes with special reference to the Middle East and Asia. Diabetes Technol Ther. 2015;17(10):676–8.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Ramachandran A, Snehalatha C, Ma RC. Diabetes in South-East Asia: an update. Diabetes Res Clin Pract. 2014;103(2):231–7.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Chakraborty C, Das S. Dynamics of diabetes and obesity: an alarming situation in the developing countries in Asia. Mini Rev Med Chem. 2016;16(15):1258–68.PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Praveen PA, Kumar SR, Tandon N. Type 2 diabetes in youth in South Asia. Curr Diab Rep. 2015;15(2):571.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301(20):2129–40.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Guglielmi C, Palermo A, Pozzilli P. Latent autoimmune diabetes in the adults (LADA) in Asia: from pathogenesis and epidemiology to therapy. Diabetes Metab Res Rev. 2012;28(Suppl 2):40–6.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Kesavadev J, Sadikot SM, Saboo B, Shrestha D, Jawad F, Azad K, et al. Challenges in type 1 diabetes management in South East Asia: descriptive situational assessment. Indian J Endocrinol Metab. 2014;18(5):600–7.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Zhang Y, Ning G. Diabetes: young-onset type 2 diabetes mellitus-a challenge for Asia. Nat Rev Endocrinol. 2014;10(12):703–4.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Tandon N, Garg MK, Singh Y, Marwaha RK. Prevalence of metabolic syndrome among urban Indian adolescents and its relation with insulin resistance (HOMA-IR). J Pediatr Endocrinol Metab. 2013;26(11–12):1123–30.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Singh Y, Garg MK, Tandon N, Marwaha RK. A study of insulin resistance by HOMA-IR and its cut-off value to identify metabolic syndrome in urban Indian adolescents. J Clin Res Pediatr Endocrinol. 2013;5(4):245–51.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Marwaha RK, Tandon N, Singh Y, Aggarwal R, Grewal K, Mani K. A study of growth parameters and prevalence of overweight and obesity in school children from Delhi. Indian Pediatr. 2006;43(11):943–52.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Praveen PA, Madhu SV, Mohan V, Das S, Kakati S, Shah N, et al. Registry of youth onset diabetes in India (YDR): rationale, recruitment, and current status. J Diabetes Sci Technol. 2016;10(5):1034–41.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Anjana RM, Shanthi Rani CS, Deepa M, Pradeepa R, Sudha V, Divya Nair H, et al. Incidence of diabetes and prediabetes and predictors of progression among Asian Indians: 10-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES). Diabetes Care. 2015;38(8):1441–8.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Deepa M, Grace M, Binukumar B, Pradeepa R, Roopa S, Khan HM, et al. High burden of prediabetes and diabetes in three large cities in South Asia: the Center for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study. Diabetes Res Clin Pract. 2015;110(2):172–82.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Cheema A, Adeloye D, Sidhu S, Sridhar D, Chan KY. Urbanization and prevalence of type 2 diabetes in southern Asia: a systematic analysis. J Glob Health. 2014;4(1):010404.PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Ranasinghe P, Jayawardena R, Katulanda P. Diabetes mellitus in South Asia: scientific evaluation of the research output. J Diabetes. 2013;5(1):34–42.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Jayawardena R, Ranasinghe P, Byrne NM, Soares MJ, Katulanda P, Hills AP. Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis. BMC Public Health. 2012;12:380.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Ramachandran A. Epidemiology of diabetes in India--three decades of research. J Assoc Physicians India. 2005;53:34–8.PubMedPubMedCentralGoogle Scholar
  29. 29.
    Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C. High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008;31(5):893–8.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR-INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017;5:585.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Sayeed MA, Hussain MZ, Banu A, Rumi MA, Azad Khan AK. Prevalence of diabetes in a suburban population of Bangladesh. Diabetes Res Clin Pract. 1997;34(3):149–55.PubMedCrossRefGoogle Scholar
  32. 32.
    Park Y, Lee H, Koh CS, Min H, Yoo K, Kim Y, et al. Prevalence of diabetes and IGT in Yonchon County, South Korea. Diabetes Care. 1995;18(4):545–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Sutanegara D, Budhiarta AA. The epidemiology and management of diabetes mellitus in Indonesia. Diabetes Res Clin Pract. 2000;50(Suppl 2):S9–S16.PubMedCrossRefGoogle Scholar
  34. 34.
    Zaini A. Where is Malaysia in the midst of the Asian epidemic of diabetes mellitus? Diabetes Res Clin Pract. 2000;50(Suppl 2):S23–8.PubMedCrossRefGoogle Scholar
  35. 35.
    Aekplakorn W, Abbott-Klafter J, Premgamone A, Dhanamun B, Chaikittiporn C, Chongsuvivatwong V, et al. Prevalence and management of diabetes and associated risk factors by regions of Thailand: third national health examination survey 2004. Diabetes Care. 2007;30(8):2007–12.PubMedCrossRefGoogle Scholar
  36. 36.
    Baltazar JC, Ancheta CA, Aban IB, Fernando RE, Baquilod MM. Prevalence and correlates of diabetes mellitus and impaired glucose tolerance among adults in Luzon. Philippines Diabetes Res Clin Pract. 2004;64(2):107–15.PubMedCrossRefGoogle Scholar
  37. 37.
    King H, Keuky L, Seng S, Khun T, Roglic G, Pinget M. Diabetes and associated disorders in Cambodia: two epidemiological surveys. Lancet. 2005;366(9497):1633–9.PubMedCrossRefGoogle Scholar
  38. 38.
    Quoc PS, Charles MA, Cuong NH, Lieu LH, Tuan NA, Thomas M, et al. Blood glucose distribution and prevalence of diabetes in Hanoi (Vietnam). Am J Epidemiol. 1994;139(7):713–22.PubMedCrossRefGoogle Scholar
  39. 39.
    Png ME, Yoong J, Phan TP, Wee HL. Current and future economic burden of diabetes among working-age adults in Asia: conservative estimates for Singapore from 2010–2050. BMC Public Health. 2016;16:153.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Ramachandran A, Ramachandran S, Snehalatha C, Augustine C, Murugesan N, Viswanathan V, et al. Increasing expenditure on health care incurred by diabetic subjects in a developing country: a study from India. Diabetes Care. 2007;30(2):252–6.PubMedCrossRefGoogle Scholar
  41. 41.
    Diabetes: the cost of diabetes in India. Health Adm. 2009;XXII:110–2.Google Scholar
  42. 42.
    Kumar A, Nagpal J, Bhartia A. Direct cost of ambulatory care of type 2 diabetes in the middle and high income group populace of Delhi: the DEDICOM survey. J Assoc Physicians India. 2008;56:667–74.PubMedGoogle Scholar
  43. 43.
    Yesudian CA, Grepstad M, Visintin E, Ferrario A. The economic burden of diabetes in India: a review of the literature. Glob Health. 2014;10:80.CrossRefGoogle Scholar
  44. 44.
    Akari S, Mateti UV, Kunduru BR. Health-care cost of diabetes in South India: a cost of illness study. J Res Pharm Pract. 2013;2(3):114–7.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Stellefson M, Dipnarine K, Stopka C. Peer reviewed: the chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis. 2013;10:E26.PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Group AC. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;2008(358):2560–72.Google Scholar
  47. 47.
    Group UPDS. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352(9131):837–53.CrossRefGoogle Scholar
  48. 48.
    Group UPDS. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ. 1998;317:703–13.CrossRefGoogle Scholar
  49. 49.
    Group HPSC. MRC/BHF Heart Protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet. 2003;361(9374):2005–16.CrossRefGoogle Scholar
  50. 50.
    International Diabetes Federation, editor. IDF diabetes atlas. 7th ed. Brussels: International Diabetes Federation; 2015. p. 1–136.Google Scholar
  51. 51.
    Ambady R, Chamukuttan S. Early diagnosis and prevention of diabetes in developing countries. Rev Endocr Metab Disord. 2008;9(3):193.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Association AD. Screening for type 2 diabetes. Diabetes Care. 2004;27(suppl 1):s11–s4.Google Scholar
  53. 53.
    Mayor S. International diabetes federation consensus on prevention of type 2 diabetes. Int J Clin Pract. 2007;61(10):1773–5.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Bansal D, Boya C, Gudala K, Rambabu V, Bhansali A. Estimating the lag between onset and diagnosis of diabetes from the prevalence of diabetic retinopathy among Indian population. Int J Diabetol Vasc Dis Res. 2017;5(2):189–95.Google Scholar
  55. 55.
    Saudek CD, Herman WH, Sacks DB, Bergenstal RM, Edelman D, Davidson MB. A new look at screening and diagnosing diabetes mellitus. J Clin Endocrinol Metabol. 2008;93(7):2447–53.CrossRefGoogle Scholar
  56. 56.
    Heine RJ, Mooy J. Impaired glucose tolerance and unidentified diabetes. Postgrad Med J. 1996;72(844):67–71.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Krishnan A, Gupta V, Ritvik BN, Thakur J. How to effectively monitor and evaluate NCD programmes in India. Indian J Community Med. 2011;36(Suppl 1):S57.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Diabetes Association of Bangladesh. Diabetes prevention programme. Available from:
  59. 59.
    Ministry of health Malaysia. National Strategic plan for non communicable diseases. In: Section NCD, editor. Putrajaya: Non-Communicable Disease Section (NCD) Disease Control Division Ministry of Health, Malaysia; 2010.Google Scholar
  60. 60.
    National Health Mission, Ministry of Health & Social Welfare India. Operational Guidelines. Prevention, screening and control of common non-communicable diseases. Hypertension, diabetes and common cancers (oral, breast, cervix). (Part of comprehensive primary health care). New Delhi: Government of India; 2017.Google Scholar
  61. 61.
    Venkataraman K, Kannan AT, Kalra OP, Gambhir JK, Sharma AK, Sundaram KR, et al. Diabetes self-efficacy strongly influences actual control of diabetes in patients attending a tertiary hospital in India. J Community Health. 2012;37(3):653–62.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Karim R, Saha R, Rahman MS, Nure A, Etu KA, Jamila U, et al. A survey of prescription pattern of anti-diabetic drugs on diabetic patients with cardiovascular complications within Dhaka metropolis. Int J Basic Clin Pharmacol. 2016;5(6):2397–402.CrossRefGoogle Scholar
  63. 63.
    Huang L-Y, Yeh H-L, Yang M-C, Shau W-Y, Su S, Lai M-S. Therapeutic inertia and intensified treatment in diabetes mellitus prescription patterns: a nationwide population-based study in Taiwan. J Int Med Res. 2016;44(6):1263–71.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Oishi M, Yamazaki K, Okuguchi F, Sugimoto H, Kanatsuka A, Kashiwagi A. Changes in oral antidiabetic prescriptions and improved glycemic control during the years 2002–2011 in Japan (JDDM32). J Diabetes Invest. 2014;5(5):581–7.CrossRefGoogle Scholar
  65. 65.
    Mohan V, Shah S, Saboo B. Current glycemic status and diabetes related complications among type 2 diabetes patients in India: data from the A1chieve study. J Assoc Physicians India. 2013;61(1 Suppl):12–5.PubMedPubMedCentralGoogle Scholar
  66. 66.
    Ramachandran A, Snehalatha C, Shetty AS, Nanditha A. Trends in prevalence of diabetes in Asian countries. World J Diabetes. 2012;3(6):110–7.PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Chowdhury TA, Lasker SS. Complications and cardiovascular risk factors in South Asians and Europeans with early-onset type 2 diabetes. QJM. 2002;95(4):241–6.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Wu AY, Kong NC, de Leon FA, Pan CY, Tai TY, Yeung VT, et al. An alarmingly high prevalence of diabetic nephropathy in Asian type 2 diabetic patients: the MicroAlbuminuria Prevalence (MAP) Study. Diabetologia. 2005;48(1):17–26.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Chan J, So W, Ko G, Tong P, Yang X, Ma R, et al. The Joint Asia Diabetes Evaluation (JADE) Program: a web-based program to translate evidence to clinical practice in type 2 diabetes. Diabet Med. 2009;26(7):693–9.PubMedCrossRefPubMedCentralGoogle Scholar
  70. 70.
    Yuyun MF, Khaw KT, Luben R, Welch A, Bingham S, Day NE, et al. Microalbuminuria, cardiovascular risk factors and cardiovascular morbidity in a British population: the EPIC-Norfolk population-based study. Eur J Cardiovasc Prev Rehabil. 2004;11:207–13.PubMedCrossRefPubMedCentralGoogle Scholar
  71. 71.
    Ting DSW, Cheung GCM, Wong TY. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clin Exp Ophthalmol. 2016;44(4):260–77.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Wang FH, Liang YB, Peng XY, Wang JJ, Zhang F, Wei WB, et al. Risk factors for diabetic retinopathy in a rural Chinese population with type 2 diabetes: the Handan Eye Study. Acta Ophthalmol. 2011;89(4):e336–e43.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Shivashankar R, Kirk K, Kim WC, Rouse C, Tandon N, Narayan KV, et al. Quality of diabetes care in low-and middle-income Asian and Middle Eastern countries (1993–2012)–20-year systematic review. Diabetes Res Clin Pract. 2015;107(2):203–23.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Singh DK, Winocour P, Farrington K. Erythropoietic stress and anemia in diabetes mellitus. Nat Rev Endocrinol. 2009;5(4):204–10.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Hosseini MS, Rostami Z, Saadat A, Saadatmand SM, Naeimi E. Anemia and microvascular complications in patients with type 2 diabetes mellitus. Nephro Urol Mon. 2014;6(4):e19976.CrossRefGoogle Scholar
  76. 76.
    Shah A, Kanaya AM. Diabetes and associated complications in the South Asian population. Curr Cardiol Rep. 2014;16(5):1–16.CrossRefGoogle Scholar
  77. 77.
    D’Souza M, Kulkarni V, Bhaskaran U, Ahmed H, Naimish H, Prakash A, et al. Diabetic peripheral neuropathy and its determinants among patients attending a tertiary health care centre in Mangalore, India. J Public Health Res. 2015;4(2):450.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Malik RA, Aldinc E, Chan S-P, Deerochanawong C, Hwu C-M, Rosales RL, et al. Perceptions of painful diabetic peripheral neuropathy in South-East Asia: results from patient and physician surveys. Adv Ther. 2017;34:1–12.CrossRefGoogle Scholar
  79. 79.
    Prabhakaran D, Jeemon P, Roy A. Cardiovascular diseases in India. Circulation. 2016;133(16):1605–20.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Ueshima H, Sekikawa A, Miura K, Turin TC, Takashima N, Kita Y, et al. Cardiovascular disease and risk factors in Asia. Circulation. 2008;118(25):2702–9.PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Mukhopadhyay B, Sattar N, Fisher M. Diabetes and cardiac disease in South Asians. Br J Diabetes Vasc Dis. 2005;5:253–9.CrossRefGoogle Scholar
  82. 82.
    Nakagami T, Qiao Q, Tuomilehto J, Balkau B, Tajima N, Hu G, et al. Screen-detected diabetes, hypertension and hypercholesterolemia as predictors of cardiovascular mortality in five populations of Asian origin: the DECODA study. Eur J Cardiovasc Prev Rehabil. 2005;13:555–61.CrossRefGoogle Scholar
  83. 83.
    Baghaei P, Marjani M, Javanmard P, Tabarsi P, Masjedi MR. Diabetes mellitus and tuberculosis facts and controversies. J Diabetes Metab Disord. 2013;12(1):58.PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. JAMA. 1999;282(7):677–86.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Chou K-L, Chi I. Prevalence of depression among elderly Chinese with diabetes. Int J Geriatr Psychiatry. 2005;20(6):570–5.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Poongothai S, Anjana RM, Pradeepa R, Ganesan A, Unnikrishnan R, Rema M, et al. Association of depression with complications of type 2 diabetes--the Chennai urban rural epidemiology study (CURES- 102). J Assoc Physicians India. 2011;59:644–8.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Nikibakht A, Moayedi F, Zare S, Mahboobi H, Banaei S, Khorgoei T, et al. Anxiety and depressionamong diabetic patients in Bandarabbas,Southern Iran. Australas Med J AMJ. 2009;1(7):25–8.Google Scholar
  88. 88.
    Larijani B, Bayat MKS, Gorgani MK, Bandarian F, Akhondzadeh S, Sadjadi SA. Association between depression and diabetes. Ger J Psychiatry. 2004;7(4):62–5.Google Scholar
  89. 89.
    Kaur G, Tee GH, Ariaratnam S, Krishnapillai AS, China K. Depression, anxiety and stress symptoms among diabetics in Malaysia: a cross sectional study in an urban primary care setting. BMC Fam Pract. 2013;14(1):69.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Zhang Y, Ting RZW, Yang W, Jia W, Li W, Ji L, et al. Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence. J Diabetes. 2015;7(6):800–8.PubMedPubMedCentralCrossRefGoogle Scholar
  91. 91.
    Baradaran HR, Mirghorbani S-M, Javanbakht A, Yadollahi Z, Khamseh ME. Diabetes distress and its association with depression in patients with type 2 diabetes in Iran. Intl J Prev Med. 2013;4(5):580–4.Google Scholar
  92. 92.
    Yoon K-HH, Lee J-HH, Kim J-WW, Cho JH, Choi Y-HH, Ko S-HH, et al. Epidemic obesity and type 2 diabetes in Asia. Lancet. 2006;368:1681–8.PubMedCrossRefPubMedCentralGoogle Scholar
  93. 93.
    Alaboud A, Tourkmani A, Alharbi T, Alobikan A, Abdelhay O, Al Batal S, et al. Microvascular and macrovascular complications of type 2 diabetic mellitus in Central, Kingdom of Saudi Arabia. Saudi Med J. 2016;37(12):1408–11.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Shaghaghi A, Ahmadi A, Matlabi H. Iranian patients require more pertinent care to prevent type 2 diabetes complications. Adv Prev Med. 2014;2014:1.CrossRefGoogle Scholar
  95. 95.
    Cc Chow F, Chan SP, Hwu CM, Suwanwalaikorn S, Wu AY, Gan SY, et al. Challenges in achieving optimal glycemic control in type 2 diabetes patients with declining renal function: the Southeast Asia perspective. J Diabetes Invest. 2012;3:481–9.CrossRefGoogle Scholar
  96. 96.
    Unnikrishnan R, Rema M, Pradeepa R, Mohan D, Shanthirani CS, Deepa R, et al. Prevalence and risk factors of diabetic nephropathy in an urban south Indian population the Chennai Urban Rural Epidemiology Study (CURES 45). Diabetes Care. 2007;30(8):2019–24.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Mafauzy M, Hussein Z, Chan SP. The status of diabetes control in Malaysia: results of DiabCare 2008. Med J Malaysia. 2011;66(3):175–81.PubMedPubMedCentralGoogle Scholar
  98. 98.
    Yoshida Y, Hagura R, Hara Y, Sugasawa G. Risk factors for the development of diabetic retinopathy in Japanese type 2 diabetic patients. Diabetes Res Clin Pract. 2001;51(3):195–203.PubMedCrossRefPubMedCentralGoogle Scholar
  99. 99.
    Shivashankar R, Bhalla S, Kondal D, Ali MK, Prabhakaran D, Narayan KV, et al. Adherence to diabetes care processes at general practices in the National Capital Region-Delhi, India. Indian J Endocr Metab. 2016;20(3):329.CrossRefGoogle Scholar
  100. 100.
    Nitiyanant W, Tandhanand S, Mahtab H, Zhu XX, Pan CY, Raheja BS, et al. The Diabcare-Asia 1998 study--outcomes on control and complications in type 1 and type 2 diabetic patients. Curr Med Res Opin. 2002;18(5):317–27.PubMedCrossRefPubMedCentralGoogle Scholar
  101. 101.
    Mohamed M, Diabcare-Asia SG. An audit on diabetes management in Asian patients treated by specialists: the Diabcare-Asia 1998 and 2003 studies. Curr Med Res Opin. 2008;24(2):507–14.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Chan JCN, Gagliardino JJ, Baik SH, Chantelot JM, Ferreira SRG, Hancu N, et al. Multifaceted determinants for achieving glycemic control the international diabetes management practice study (IDMPS). Diabetes Care. 2009;32(2):227–33.PubMedPubMedCentralCrossRefGoogle Scholar
  103. 103.
    International Diabetes Federation, editor. IDF diabetes atlas. 7th ed. Brussels: International Diabetes Federation; 2015.Google Scholar
  104. 104.
    WHO. Diabetes country profiles 2016. Geneva: WHO; 2016. Available from
  105. 105.
    International Diabetes Federation. Global diabetes score card. Brussels: International Diabetes Federation; 2014. Available from
  106. 106.
    International Diabetes Federation. IDF diabetes atlas. 7th ed. Brussels: International Diabetes Federation; 2015. Report No.: 9782930229812.Google Scholar
  107. 107.
    Hashmi NR, Khan SA. Adherence to diabetes mellitus treatment guidelines from theory to practice: the missing link. J Ayub Med Coll Abbottabad. 2016;28(4):802–8.PubMedPubMedCentralGoogle Scholar
  108. 108.
    Joshi SR, Das AK, Vijay VJ, Mohan V. Challenges in diabetes care in India: sheer numbers, lack of awareness and inadequate control. J Assoc Physicians India. 2008;56:443–50.PubMedPubMedCentralGoogle Scholar
  109. 109.
    Baumann LC, Blobner D, Van Binh T, Lan PT. A training program for diabetes care in Vietnam. Diabetes Educ. 2006;32(2):189.PubMedCrossRefPubMedCentralGoogle Scholar
  110. 110.
    Lee YK, Lee PY, Ng CJ. A qualitative study on healthcare professionals’ perceived barriers to insulin initiation in a multi-ethnic population. BMC Fam Pract. 2012;13(1):28.PubMedPubMedCentralCrossRefGoogle Scholar
  111. 111.
    Sun N, Rau P-LP. Barriers to improve physician–patient communication in a primary care setting: perspectives of Chinese physicians. Health Psychol Behav Med. 2017;5(1):166–76.CrossRefGoogle Scholar
  112. 112.
    Alkhaifi MA, Khusaibi GA, Theodorson T, Ward MA, Mazrou’I AA. Barriers in initiating insulin treatment in type 2 diabetes mellitus among physicians in Wilayat of Bowsher in Oman. J Family Med Community Health. 2015;2(3):1034.Google Scholar
  113. 113.
    Finucane ML, McMullen CK. Making diabetes self-management education culturally relevant for Filipino Americans in Hawaii. Diabetes Educ. 2008;34(5):841–53.PubMedCrossRefPubMedCentralGoogle Scholar
  114. 114.
    Rafique G, Shaikh F. Identifying needs and barriers to diabetes education in patients with diabetes. J Pak Med Assoc. 2006;56(8):347–52.PubMedPubMedCentralGoogle Scholar
  115. 115.
    Mendenhall E, Shivashankar R, Tandon N, Ali MK, Venkat Narayan KM, Prabhakaran D. Stress and diabetes in socioeconomic context: a qualitative study of urban Indians. Soc Sci Med. 2012;75(12):2522–9.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Shobhana R, Rao R, Lavanya A, Padma C, Vijay V, Ramachandran A. Quality of life and diabetes integration among subjects with type 2 diabetes. J Assoc Physicians India. 2003;51:363–5.PubMedPubMedCentralGoogle Scholar
  117. 117.
    Kelleher D, Islam S. The problem of integration: Asian people and diabetes. J R Soc Med. 1994;87(7):414–7.PubMedPubMedCentralGoogle Scholar
  118. 118.
    Sowattanangoon N, Kotchabhakdi N, Petrie KJ. The influence of Thai culture on diabetes perceptions and management. Diabetes Res Clin Pract. 2009;84(3):245–51.PubMedCrossRefPubMedCentralGoogle Scholar
  119. 119.
    Sowattanangoon N, Kochabhakdi N, Petrie KJ. Buddhist values are associated with better diabetes control in Thai patients. Int J Psychiatry Med. 2008;38(4):481–91.PubMedCrossRefPubMedCentralGoogle Scholar
  120. 120.
    Joshi AS, Varthakavi PK, Bhagwat NM, Chadha MD, Parmar G. Fasts, feasts, and festivals in diabetes: glycemic management during Parsi rituals. Indian J Endocr Metab. 2015;19(5):680–2.CrossRefGoogle Scholar
  121. 121.
    Sabra AA, Taha AZ, Al-Zubier AG, Al-Kurashi NY. Misconceptions about diabetes mellitus among adult male attendees of primary health care centres in Eastern Saudi Arabia. S Afr Fam Pract. 2014;52(4):344–9.Google Scholar
  122. 122.
    Naeem AG, Ag N. The role of culture and religion in the management of diabetes: a study of Kashmiri men in Leeds. J R Soc Promot Health. 2003;123(2):110–6.PubMedCrossRefPubMedCentralGoogle Scholar
  123. 123.
    Kalra S, Bajaj S, Gupta Y, Agarwal P, Singh SK, Julka S, et al. Fasts, feasts and festivals in diabetes-1: glycemic management during Hindu fasts. Indian J Endocrinol Metab. 2015;19(2):198–203.PubMedPubMedCentralCrossRefGoogle Scholar
  124. 124.
    Hassanein M, Belhadj M, Abdallah K, Bhattacharya AD, Singh AK, Tayeb K, et al. Management of type 2 diabetes in Ramadan: low-ratio premix insulin working group practical advice. Indian J Endocrinol Metab. 2014;18(6):794–9.PubMedPubMedCentralCrossRefGoogle Scholar
  125. 125.
    Lawton J, Ahmad N, Hanna L, Douglas M, Hallowell N. I can’t do any serious exercise’: barriers to physical activity amongst people of Pakistani and Indian origin with type 2 diabetes. Health Educ Res. 2006;21(1):43–54.PubMedCrossRefPubMedCentralGoogle Scholar
  126. 126.
    Sohal T, Sohal P, King-Shier KM, Khan NA. Barriers and facilitators for type-2 diabetes management in South Asians: a systematic review. PLoS One. 2015;10(9):e0136202.PubMedPubMedCentralCrossRefGoogle Scholar
  127. 127.
    Mathews E, Lakshmi JK, Ravindran STK, Pratt M. Perceptions of barriers and facilitators in physical activity participation among women in Thiruvananthapuram City, India. Glob Health Promot. 2016;23(4):27–36.PubMedCrossRefPubMedCentralGoogle Scholar
  128. 128.
    Ramanathan S, Crocker PR. The influence of family and culture on physical activity among female adolescents from the Indian diaspora. Qual Health Res. 2009;19(4):492–503.PubMedCrossRefPubMedCentralGoogle Scholar
  129. 129.
    Kumar K, Greenfield S, Raza K, Gill P, Stack R. Understanding adherence-related beliefs about medicine amongst patients of South Asian origin with diabetes and cardiovascular disease patients: a qualitative synthesis. BMC Endocr Disord. 2016;16(1):24.PubMedPubMedCentralCrossRefGoogle Scholar
  130. 130.
    Sekhar TV, Shabana S, Bhargav SY. Gender: does it have role has a role in glycaemic control and diabetic distress in type 2 diabetes? IOSR J Dent Med Sci. 2013;4(6):2279–861.Google Scholar
  131. 131.
    Loizzo MR, Saab AM, Tundis R, Menichini F, Bonesi M, Piccolo V, et al. In vitro inhibitory activities of plants used in Lebanon traditional medicine against angiotensin converting enzyme (ACE) and digestive enzymes related to diabetes. J Ethnopharmacol. 2008;119(1):109–16.PubMedCrossRefPubMedCentralGoogle Scholar
  132. 132.
    Hamdan II, Afifi FU. Studies on the in vitro and in vivo hypoglycemic activities of some medicinal plants used in treatment of diabetes in Jordanian traditional medicine. J Ethnopharmacol. 2004;93(1):117–21.PubMedCrossRefPubMedCentralGoogle Scholar
  133. 133.
    Umashanker M, Shruti S. Traditional Indian herbal medicine used as antipyretic, antiulcer, anti-diabetic and anticancer: a review. IJRPC. 2011;1(4):1152–9.Google Scholar
  134. 134.
    Dham S, Shah V, Hirsch S, Banerji MA. The role of complementary and alternative medicine in diabetes. Curr Diab Rep. 2006;6(3):251–8.PubMedCrossRefPubMedCentralGoogle Scholar
  135. 135.
    Chimkode SM, Kumaran SD, Kanhere VV, Shivanna R. Effect of yoga on blood glucose levels in patients with type 2 diabetes mellitus. J Clin Diagnostic Res. 2015;9(4):CC01–3.Google Scholar
  136. 136.
    Malhotra V, Singh S, Tandon OP, Sharma SB. The beneficial effect of yoga in diabetes. Nepal Med Coll J. 2005;7(2):145–7.PubMedPubMedCentralGoogle Scholar
  137. 137.
    Sahay B. Role of yoga in diabetes. JAPI. 2007;55:121–6.PubMedGoogle Scholar
  138. 138.
    Kar A, Choudhary BK, Bandyopadhyay NG. Comparative evaluation of hypoglycaemic activity of some Indian medicinal plants in alloxan diabetic rats. J Ethnopharmacol. 2003;84(1):105–8.PubMedCrossRefGoogle Scholar
  139. 139.
    Covington MB. Traditional Chinese medicine in the treatment of diabetes. Diabetes Spectr. 2001;14(3):154–9.CrossRefGoogle Scholar
  140. 140.
    Hasan SS, Ahmed SI, Bukhari NI, Loon WCW. Use of complementary and alternative medicine among patients with chronic diseases at outpatient clinics. Complement Ther Clin Pract. 2009;15(3):152–7.PubMedCrossRefGoogle Scholar
  141. 141.
    Li WL, Zheng HC, Bukuru J, De Kimpe N. Natural medicines used in the traditional Chinese medical system for therapy of diabetes mellitus. J Ethnopharmacol. 2004;92:1–21.PubMedCrossRefGoogle Scholar
  142. 142.
    Medagama AB, Bandara R, Abeysekera RA, Imbulpitiya B, Pushpakumari T. Use of Complementary and Alternative Medicines (CAMs) among type 2 diabetes patients in Sri Lanka: a cross sectional survey. BMC Complementary Altern Med. 2014;14:374.CrossRefGoogle Scholar
  143. 143.
    Khalaf AJ, Whitford DL. The use of complementary and alternative medicine by patients with diabetes mellitus in Bahrain: a cross-sectional study. BMC Complementary Altern Med. 2010;10:35.CrossRefGoogle Scholar
  144. 144.
    Chang H-YA, Wallis M, Tiralongo E. Use of complementary and alternative medicine among people with type 2 diabetes in Taiwan: a cross-sectional survey. Evid Based Complement Alternat Med. 2011;2011:1.Google Scholar
  145. 145.
    Alfian S, Sukandar H, Arisanti N, Abdulah R. Complementary and alternative medicine use decreases adherence to prescribed medication in diabetes patients. Ann Trop Med Public Health. 2016;9(3):174–9.CrossRefGoogle Scholar
  146. 146.
    Chamberlain JJ, Herman WH, Leal S, Rhinehart AS, Shubrook JH, Skolnik N, et al. Pharmacologic therapy for type 2 diabetes: synopsis of the 2017 American Diabetes Association Standards of Medical Care in diabetes. Ann Intern Med. 2017;166(8):572–8.PubMedCrossRefPubMedCentralGoogle Scholar
  147. 147.
    American Diabetes Association. Standards of Medical Care in Diabetes-2017 Abridged for Primary Care Providers. Clin Diabetes. 2017;35(1):5–26.PubMedCentralCrossRefGoogle Scholar
  148. 148.
    Armstrong C. ADA updates standards of medical care for patients with diabetes mellitus. Am Fam Physician. 2017;95(1):40–3.PubMedPubMedCentralGoogle Scholar
  149. 149.
    Marathe PH, Gao HX, Close KL. American Diabetes Association Standards of Medical Care in diabetes 2017. J Diabetes. 2017;9(4):320–4.PubMedCrossRefPubMedCentralGoogle Scholar
  150. 150.
    Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358(6):580–91.PubMedPubMedCentralCrossRefGoogle Scholar
  151. 151.
    Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348(5):383–93.PubMedCrossRefPubMedCentralGoogle Scholar
  152. 152.
    Gaede PH, Jepsen PV, Larsen JN, Jensen GV, Parving HH, Pedersen OB. The Steno-2 study. Intensive multifactorial intervention reduces the occurrence of cardiovascular disease in patients with type 2 diabetes. Ugeskr Laeger. 2003;165(26):2658–61.PubMedPubMedCentralGoogle Scholar
  153. 153.
    Shivashankar R, Kirk K, Kim WC, Rouse C, Tandon N, Narayan KM, et al. Quality of diabetes care in low- and middle-income Asian and Middle Eastern countries (1993–2012): 20-year systematic review. Diabetes Res Clin Pract. 2015;107(2):203–23.PubMedCrossRefPubMedCentralGoogle Scholar
  154. 154.
    Pendsey S, Abbas ZG. The step-by-step program for reducing diabetic foot problems: a model for the developing world. Curr Diab Rep. 2007;7(6):425–8.PubMedCrossRefGoogle Scholar
  155. 155.
  156. 156.
    Ramachandran A. Specific problems of the diabetic foot in developing countries. Diabetes Metab Res Rev. 2004;20(Suppl 1):S19–22.PubMedCrossRefGoogle Scholar
  157. 157.
    Abbas ZG, Lutale JK, Bakker K, Baker N, Archibald LK. The ‘Step by Step’ Diabetic Foot Project in Tanzania: a model for improving patient outcomes in less-developed countries. Int Wound J. 2011;8(2):169–75.PubMedCrossRefGoogle Scholar
  158. 158.
    Bhalla S, Unnikrishnan R, Srivastava R, Tandon N, Mohan V, Prabhakaran D. Innovation in capacity building of primary-care physicians in diabetes management in India: a new slant in medical education. Lancet Diabetes Endocrinol. 2016;4(3):200–2.PubMedCrossRefGoogle Scholar
  159. 159.
    Fisher EB, Boothroyd RI, Coufal MM, Baumann LC, Mbanya JC, Rotheram-Borus MJ, et al. Peer support for self-management of diabetes improved outcomes in international settings. Health Aff (Millwood). 2012;31(1):130–9.CrossRefGoogle Scholar
  160. 160.
    Shah S, Singh K, Ali MK, Mohan V, Kadir MM, Unnikrishnan AG, et al. Improving diabetes care: multi-component cardiovascular disease risk reduction strategies for people with diabetes in South Asia--the CARRS multi-center translation trial. Diabetes Res Clin Pract. 2012;98(2):285–94.PubMedPubMedCentralCrossRefGoogle Scholar
  161. 161.
    Ali MK, Singh K, Kondal D, Devarajan R, Patel SA, Shivashankar R, et al. Effectiveness of a multicomponent quality improvement strategy to improve achievement of diabetes care goals: a randomized. Control Trial Ann Intern Med. 2016;165(6):399–408.CrossRefGoogle Scholar
  162. 162.
    Sun J, Wang Y, Chen X, Chen Y, Feng Y, Zhang X, et al. An integrated intervention program to control diabetes in overweight Chinese women and men with type 2 diabetes. Asia Pac J Clin Nutr. 2008;17(3):514–24.PubMedGoogle Scholar
  163. 163.
    Prathiba V, Rema M. Teleophthalmology: a model for eye care delivery in rural and underserved areas of India. Int J Family Med. 2011;2011:683267.PubMedPubMedCentralCrossRefGoogle Scholar
  164. 164.
    Mohan V, Deepa M, Pradeepa R, Prathiba V, Datta M, Sethuraman R, et al. Prevention of diabetes in rural India with a telemedicine intervention. J Diabetes Sci Technol. 2012;6(6):1355–64.PubMedPubMedCentralCrossRefGoogle Scholar
  165. 165.
    Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20(4):537–44.PubMedCrossRefGoogle Scholar
  166. 166.
    Saito T, Watanabe M, Nishida J, Izumi T, Omura M, Takagi T, et al. Lifestyle modification and prevention of type 2 diabetes in overweight Japanese with impaired fasting glucose levels: a randomized controlled trial. Arch Intern Med. 2011;171(15):1352–60.PubMedCrossRefGoogle Scholar
  167. 167.
    Ramachandran A, Arun N, Shetty AS, Snehalatha C. Efficacy of primary prevention interventions when fasting and postglucose dysglycemia coexist: analysis of the Indian Diabetes Prevention Programmes (IDPP-1 and IDPP-2). Diabetes Care. 2010;33(10):2164–8.PubMedPubMedCentralCrossRefGoogle Scholar
  168. 168.
    Snehalatha C, Mary S, Selvam S, Sathish Kumar CK, Shetty SB, Nanditha A, et al. Changes in insulin secretion and insulin sensitivity in relation to the glycemic outcomes in subjects with impaired glucose tolerance in the Indian Diabetes Prevention Programme-1 (IDPP-1). Diabetes Care. 2009;32(10):1796–801.PubMedPubMedCentralCrossRefGoogle Scholar
  169. 169.
    Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. The Indian diabetes prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006;49(2):289–97.PubMedCrossRefGoogle Scholar
  170. 170.
    Ramachandran A, Snehalatha C, Ram J, Selvam S, Simon M, Nanditha A, et al. Effectiveness of mobile phone messaging in prevention of type 2 diabetes by lifestyle modification in men in India: a prospective, parallel-group, randomised controlled trial. Lancet Diabetes Endocrinol. 2013;1(3):191–8.PubMedCrossRefGoogle Scholar
  171. 171.
    Wijesuriya M, Gulliford M, Vasantharajah L, Viberti G, Gnudi L, Karalliedde J. DIABRISK-SL prevention of cardio-metabolic disease with life style modification in young urban Sri Lankan’s--study protocol for a randomized controlled trial. Trials. 2011;12:209.PubMedPubMedCentralCrossRefGoogle Scholar
  172. 172.
    Weber MB, Ranjani H, Meyers GC, Mohan V, Narayan KM. A model of translational research for diabetes prevention in low and middle-income countries: the Diabetes Community Lifestyle Improvement Program (D-CLIP) trial. Prim Care Diabetes. 2012;6(1):3–9.PubMedCrossRefGoogle Scholar
  173. 173.
    Weber MB, Harish R, Staimez LR, Anjana RM, Ali MK, Narayan KMV. 180-LB reduction in diabetes incidence differs by prediabetes type in a randomized translational trial of prevention. Diabetes. 2015;64(Suppl 1A):LB46.Google Scholar
  174. 174.
    Oba N, McCaffrey R, Choonhapran P, Chutug P, Rueangram S. Development of a community participation program for diabetes mellitus prevention in a primary care unit, Thailand. Nurs Health Sci. 2011;13(3):352–9.PubMedGoogle Scholar
  175. 175.
    Sranacharoenpong K, Hanning RM. Diabetes prevention education program for community health care workers in Thailand. J Community Health. 2012;37(3):610–8.PubMedCrossRefPubMedCentralGoogle Scholar
  176. 176.
    Ali MK, Echouffo-Tcheugui J, Williamson DF. How effective were lifestyle interventions in real-world settings that were modeled on the Diabetes Prevention Program? Health Aff (Millwood). 2012;31(1):67–75.CrossRefGoogle Scholar
  177. 177.
    Mohan V, Anbalagan VP. Expanding role of the Madras diabetes research foundation – Indian diabetes risk score in clinical practice. Indian J Endocrinol Metab. 2013;17(1):31–6.PubMedPubMedCentralCrossRefGoogle Scholar

Suggested/Further Reading

  1. Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, Hu FB. Diabetes in Asia: epidemiology, risk factors, and pathophysiology. JAMA. 2009;301(20):2129–40.PubMedCrossRefPubMedCentralGoogle Scholar
  2. Misra A, Tandon N, Ebrahim S, Sattar N, Alam D, Shrivastava U, Narayan KM, Jafar TH. Diabetes, cardiovascular disease, and chronic kidney disease in South Asia: current status and future directions. BMJ. 2017;357:j1420.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Roopa Shivashankar
    • 1
    • 2
    Email author
  • Kavita Singh
    • 1
    • 2
  • L. R. Aravind
    • 3
  • Nikhil Tandon
    • 4
  1. 1.Public Health Foundation of India (PHFI)GurgaonIndia
  2. 2.Centre for Chronic Disease ControlNew DelhiIndia
  3. 3.Public Health Foundation of India (PHFI)GurgaonIndia
  4. 4.Department of Endocrinology and MetabolismAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations