A new set of guidelines for managing diabetes released by the American College of Physicians (ACP) has riled up the Indian medical fraternity, according to a report in The Times of India. The doctors are questioning some of the controversial clauses that replace the older ones followed by Indian doctors for over three decades. One norm in particular, which calls for relaxing the blood sugar target is particularly contentious. Advising that these rules be ignored in the Indian context, medicos content it will lead to complications in the disease and create confusion for the physicians who are treating the patients.

What are these new guidelines?

The new guidelines from ACP recommend that treatment of diabetes should be personalised by discussing drug therapy, and understanding patient preferences, treatment burden and cost.

Earlier guidelines recommended that the physicians should maintain the glycated haemoglobin (HbA1c) levels of diabetes patients at 7 percent or below. But now, the ACP has relaxed the rules, recommending that physicians should aim for HbA1c between 7 percent and 8 percent.

ACP has also asked the physicians to decrease the drug dosage for patients whose HbA1c level below 6.5 to prevent complications from hypoglycaemia.

The guidelines also state that the doctors should aim to minimise the symptoms of low blood sugar. And in patients with a life expectancy of less than 10 years, treatment targeting A1C level should be avoided because it does more harm than good.

What do Indian doctors say?

The Indian doctors are up in arms against the new ruling because they say that the situation in India vis-à-vis diabetes is quite different from that in the west. In India, diabetes is gaining an epidemic status, and the relaxation of the criteria for HbA1c could prove dangerous for treating diabetes patients in the country. They believe that in the Indian context, it would be best to stick to HbA1c of 7 percent or below.

The Indian medical fraternity backs their claim with studies saying that maintenance of HbA1c below 7 percent or below prevents nerve, eye and kidney problems.

The Indian doctors are taking a united stand against standardising the rules for treating diabetes saying that by relaxing the upper limit of blood sugar control, the new ACP guidelines will cause more complications and endanger more lives. The doctors reject the recommendations, saying that India-specific guidelines for diabetes chalked by the Indian Council of Medical Research, Research Society For The Study of Diabetes in India and Association of Physicians of India should be followed instead.

(The above story first appeared on LatestLY on Mar 20, 2018 11:12 AM IST. For more news and updates on politics, world, sports, entertainment and lifestyle, log on to our website latestly.com).