There are few studies on type 2 diabetes complications from Indian metropolitan and non-metropolitan cities. Macrovascular and microvascular complications during the second year of LANDMARC, a 3-year nationwide prospective observational study (CTRI/2017/05/008452) , were evaluated in participants from metropolitan versus non-metropolitan cities. LANDMARC included participants with T2D who were on ≥2 antihyperglycemic medications. Of the total 6234 participants, 2376 and 3858 were from metropolitan and non-metropolitan cities, respectively. Age, T2D duration, and baseline A1C were similar across groups. Microvascular complications were significantly higher in participants from non-metropolitan than metropolitan cities (12.93% vs. 4.65%; p<0.0001) during the 2 years. Neuropathy was the most common microvascular complication in both metropolitan and non-metropolitan cities. Among macrovascular complications, a greater number of participants reported heart failure (p=0.0160) and CV deaths in non-metropolitan cities than metropolitan cities (Table) . The present data from India demonstrates that participants from non-metropolitan cities may have higher complications, particularly microvascular, and may need to be better understood through future studies. The LANDMARC results elicit a pattern of disease progression among participants with T2D.
S. Kalra: Speaker's Bureau; Boehringer Ingelheim International GmbH, Novo Nordisk A/S, Sanofi. A.K. Das: Advisory Panel; Boehringer Ingelheim International GmbH, Novo Nordisk, Roche Diagnostics, Sanofi. Speaker's Bureau; Dr. Reddy’s Laboratories Ltd., Lupin Pharmaceuticals, Inc., USV Private Limited. S. Joshi: Advisory Panel; Abbott, Boehringer Ingelheim International GmbH, Dr. Reddy's Laboratories Ltd., Eli Lilly and Company, Novo Nordisk, Roche Diabetes Care. Consultant; Biocon, Glenmark Pharmaceuticals, Sanofi, USV Private Limited. A. Mithal: Advisory Panel; Eris Lifesciences Ltd. Consultant; Glenmark Pharmaceuticals, Lupin Pharmaceuticals, Inc., USV Private Limited. Speaker's Bureau; Abbott Diabetes, AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Dr. Reddy’s Laboratories Ltd., Novartis AG, Novo Nordisk, Sanofi. K. Kumar: None. A. Unnikrishnan: Advisory Panel; Intas Pharmaceuticals Ltd. Speaker's Bureau; Abbott, AstraZeneca, Boehringer-Ingelheim, Sanofi. Other Relationship; Novo Nordisk, Serdia Pharmaceuticals (India) Pvt. Ltd., Torrent Pharmaceuticals Ltd. H. Thacker: None. B. Sethi: None. S. Chowdhury: None. A. Nair: None. S. Mohanasundaram: Employee; Sanofi. V. Salvi: Employee; Sanofi. D. Chodankar: Employee; Sanofi. C. Trivedi: None. S. Wangnoo: None. A.H. Zargar: Advisory Panel; Sanofi. Speaker's Bureau; AstraZeneca, Biocon, Boehringer Ingelheim International GmbH, Intas Pharmaceuticals Ltd., Janssen Pharmaceuticals, Inc., Lupin Pharmaceuticals, Inc., Novo Nordisk, USV Private Limited. N. Rais: None.