Pingili et al. Rejoinder to: Basu’s “Letter to the Editor”
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As Dr. Saurav commented, a prospective or repeated cross-sectional study design would have been more desirable to assess glycemic control (HbA1c) in diabetic patients. We agree to that, but here we have conducted a cross-sectional study on risk factors and prescription adherence. Even though we have taken HbA1c values at the time of interview, all the patients are diabetic for the last few years. We have mentioned the same thing in the section of participant selection (i. e., patients of either sex diagnosed with T2DM of any duration (as per AACE guidelines) and willing to participate were included in the study) and we have excluded newly diagnosed diabetic patients and diabetic patients on anti-diabetic therapy for < 1 year. That indicates they are diabetic for the last several years and their HbA1c levels were checked by the physicians at stipulated time periods. So we requested the physicians to give the data not exceeding 6 months and we observed that most of the prescriptions (80–85%) are adhering to AACE guidelines. In this study, the observed non adherence was 15–20%.
As Dr. Saurav commented, glycemic controls in a majority of diabetics are subject to variability with time and religious festivities which may be of considerable duration extending for several days or even weeks which would render older HbA1c reports as non-representative of the current glycemic control. We also agree to that, if we conduct a repeated cross-sectional study or a prospective study or a case control study with sufficient number of participants, the non-adherence may reduce further. Our study focused mainly on risk factors and little on prescription adherence. Currently, we focused and working only on prescription adherence to several other standard guidelines in a prospective study along with quality of life and also working on diabetic complications. The study is not completed yet, and we are extending further. Soon we will complete the study. Other researchers also can conduct similar kind of study in other regions of India, and then we can improve the quality of life of our beloved people.