1
|
Anand K, Jain S. Impact of Lifestyle Modification: An Intervention on Newly Diagnosed Diabetics of the Urban Slum of Meerut. Cureus 2024; 16:e58844. [PMID: 38784317 PMCID: PMC11115446 DOI: 10.7759/cureus.58844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Diabetes is a long-term condition that necessitates ongoing medical attention and self-care to prevent immediate complications and minimize the likelihood of long-term issues. Early diagnosis is one of the most important steps for people living with diabetes to take. Public awareness regarding the importance of lifestyle modification in managing type 2 diabetes mellitus is a crucial preventive measure. Despite continuous efforts to raise public awareness, the prevalence of type 2 diabetes continues to increase, with most people overlooking the importance of a healthy lifestyle. Our goal was to assess the impact of lifestyle modification on glycemic control in newly diagnosed diabetic patients. Materials and methods A total of 503 adults aged 30 years and above who were nondiabetic or were unaware of their diabetic status were assessed for their fasting blood glucose levels. Individuals identified as diabetic based on their fasting blood glucose levels were subjected to lifestyle modification for a period of three months. Glycemic levels were measured at the beginning and the end of the study period for comparison. Results Of the study participants, 7.6% were undiagnosed diabetics with increased blood sugar levels who were unaware of their diabetic status. Mean anthropometric measurements from pre- to postintervention values improved overall. Overall reduction was observed in weight (66.21±12.97 to 63.18±11.48), waist circumference (96.21±13.01 to 91.77±11.82), hip circumference (105.16±11.91 to 103.58±10.88), waist-hip ratio (0.91±0.09 to 0.88±0.08) and body mass index (27.48±6.04 to 26.18±5.30). Significant reductions were observed in the mean glycemic values, including fasting blood sugar (180.19±55.81 to 152.56±45.74) and glycosylated hemoglobin levels (8.61±1.97 to 6.68±1.67). Conclusion Lifestyle modification plays a crucial role in managing diabetes, both in preventing its onset and controlling its progression. The present study highlights the importance of early diagnosis and lifestyle interventions in the management of diabetes, thereby stressing the necessity of comprehensive strategies to combat this situation.
Collapse
Affiliation(s)
- Komal Anand
- Department of Community Medicine, Sarojini Naidu (SN) Medical College, Agra, IND
| | - Seema Jain
- Department of Community Medicine, Lala Lajpat Rai Memorial (LLRM) Medical College, Meerut, IND
| |
Collapse
|
2
|
Sujata S, B G, Thakur R. A Vulnerability Index for Mitigation and Prevention of Diabetes Growth in India: A Disaggregated Analysis. Value Health Reg Issues 2024; 40:89-99. [PMID: 38061309 DOI: 10.1016/j.vhri.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 08/29/2023] [Accepted: 09/22/2023] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study aimed to provide a vulnerability index (VI) for identifying vulnerable regions in different states of India, which may serve as a tool for state- and district-level planning for mitigation and prevention of diabetes growth in the country. METHODS Using data on 13 indicators under 4 domains, we generated domain-specific and overall VIs at state (36 states/union territories) and district levels (640 districts) using the percentile ranking method. The association of diabetes with individuals' socioeconomic status at different levels of regional vulnerability has also been observed through multivariable logistic regression models. RESULTS On a scale of 0 to 1, there are 13 states with an overall VI of >0.70, of which 5 states are from southern regions of India. A low VI has been achieved by socioeconomically backward states. We observed that prevalence rates and vulnerability levels for most of the top and bottom 11 states are in the same line. District-level analysis showed that the 20 most vulnerable and least vulnerable districts are mostly from coastal and socioeconomically backward states of the country, respectively. Furthermore, logistic regression revealed that rural adults and females are less likely to be diabetic in all vulnerability quartiles. The oldest, Muslims, wealthiest, widowed/deserted/separated, and those with schooling ≤12 years are significantly more likely to be diabetic than their counterparts. CONCLUSION The constructed VI is vital for identifying vulnerable areas and planners and policy-makers may use this comprehensive index and domain-specific VIs to prioritize resource allocation.
Collapse
Affiliation(s)
- Sujata Sujata
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Kamand Campus, Himachal Pradesh, India
| | - Gayathri B
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Kamand Campus, Himachal Pradesh, India
| | - Ramna Thakur
- School of Humanities and Social Sciences, Indian Institute of Technology Mandi, Kamand Campus, Himachal Pradesh, India.
| |
Collapse
|
3
|
Dandona S, Tuteja N, Goel NK, Kalia M, Walia D. Assessment of the risk of developing type 2 diabetes using the Indian diabetes risk score in an urban community in Chandigarh, India: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:433. [PMID: 38464639 PMCID: PMC10920686 DOI: 10.4103/jehp.jehp_573_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 05/31/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND The urban poor is a group that is known to be vulnerable to the adoption of a more urbanized lifestyle that places them at a higher risk for diabetes. Identification of at-risk individuals using simple screening tools like the Indian diabetes risk score developed by Madras Diabetes Research Foundation (MDRF-IDRS) and appropriate lifestyle interventions could greatly help in preventing or postponing the onset of diabetes and thus reducing the burden of the disease on the community and the nation as a whole. MATERIALS AND METHODS A cross-sectional study was conducted on individuals ≥30 years (n = 1533) of both genders in an urban colony of Chandigarh during a period of 1 year. A stratified two-stage systematic random sampling was adopted. The risk of developing Type 2 diabetes mellitus was assessed using IDRS. The total risk score of each participant was analyzed and compared. Biochemical investigations, including blood glucose and lipid profiles for detecting diabetes, were conducted. Data were presented in percentages and proportions. The statistical analysis of the data was performed by using the Chi-square test and logistic regression analysis. RESULTS The prevalence of diabetes was 3.1% in the present study. Overall, the mean IDRS was found to be 52.14 ± 16.01. Elderly persons aged 60 years and above had higher IDRS. IDRS showed significant variability with age (P < 0.001). Females had significantly higher IDRS as compared to males (P = 0.002). The association between socioeconomic class and risk status was highly significant statistically (P < 0.001). IDRS among individuals with diabetes was found to be significantly higher (64.29 ± 13.92) as compared to non-diabetics. Among all, 749 (48.7%) had high IDRS, whereas 54 (3.5%) had low IDRS. There were 734 (47.8%) with moderate IDRS. CONCLUSION IDRS was found to be highly sensitive for detecting the risk of diabetes, suggesting its potential use as a screening tool in community setup for the purpose of detecting diabetes.
Collapse
Affiliation(s)
- Shaily Dandona
- Department of Community Medicine, North DMC Medical College and Hindu Rao Hospital, New Delhi, India
| | - Naman Tuteja
- Department of Orthopaedics, North DMC Medical College and Hindu Rao Hospital, Delhi, India
| | - Naveen K. Goel
- Department of Community Medicine, GMCH-32, Chandigarh, India
| | - Meenu Kalia
- Department of Community Medicine, GMCH-32, Chandigarh, India
| | - Dinesh Walia
- Department of Community Medicine, GMCH-32, Chandigarh, India
| |
Collapse
|
4
|
Andargie TA, Mengistu B, Baffa LD, Gonete KA, Belew AK. Magnitude and predictors of pre-diabetes among adults in health facilities of Gondar city, Ethiopia: a cross-sectional study. Front Public Health 2023; 11:1164729. [PMID: 38162615 PMCID: PMC10754951 DOI: 10.3389/fpubh.2023.1164729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Impaired glucose tolerance currently affects 374 million (7.5%) people worldwide, and by 2030, this number is predicted to affect 454 million (8%). Urban inhabitants have an increased risk of developing pre-diabetes. Thus, the study aimed to assess the magnitude of pre-diabetes and associated factors among adults attending outpatient departments of the health facilities of Gondar, Ethiopia. Method From 3 March to 18 April 2020, an institution-based cross-sectional study was conducted. A systematic random sampling technique was used to select 992 participants. Data were gathered using an interviewer-administered questionnaire, and fasting blood glucose was assessed using capillary blood. Bivariable and multivariable binary logistic regression analyses were fitted to check the association between independent variables and pre-diabetes. Statistical significance was declared at a level of P of <0.05. Results The prevalence of pre-diabetes was 16.6% (95% CIs: 14.3-18.8%). Age [AOR = 3.66, 95% CIs (2.05, 6.52)], a family history of diabetes mellitus [AOR = 3.46, 95% CIs (2.16, 5.52)], waist circumference [AOR = 3.6, 95% CIs (2.26, 5.88)], physical activity [AOR: 5.02, 95% CIs (2.87, 8.77)], dietary diversity [AOR = 3.07, 95% CIs (1.95, 4.84)], and smoking [AOR = 2.9, 95% CI (1.42, 6.05)] were factors associated with pre-diabetes. Conclusion From our study, we can conclude that one in six adults in the health facilities have pre-diabetes. Age, family history of diabetes, waist circumference, physical activity, dietary diversity, and smoking were the factors associated with pre-diabetes. Therefore, it is recommended that adults should be educated on modifying their lifestyle, including their diet, and substantial care should be provided for older adults.
Collapse
Affiliation(s)
| | - Berhanu Mengistu
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Lemlem Daniel Baffa
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Kedir Abdela Gonete
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia
| | - Aysheshim Kassahun Belew
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
5
|
Das U, Kar N. Prevalence and risk factor of diabetes among the elderly people in West Bengal: evidence-based LASI 1st wave. BMC Endocr Disord 2023; 23:170. [PMID: 37568234 PMCID: PMC10416355 DOI: 10.1186/s12902-023-01421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND The complication of Diabetes is one of the important health issues among the older adult population in any region. The higher risks of diabetes prevalence among older adult people in the countries was due to social-cultural changes such as increasing urbanization, dietary changes, without physical activity, and unhealthy lifestyle behavior. The present study examines the prevalence and associated risk factors of diabetes among older adults in the state of West Bengal. METHODS The first wave of the Longitudinal Ageing Study in India 2017-18 was used to achieve the study objectives. Descriptive statistics with multinomial logistic regression models were used to carry out crude and adjusted odds ratios with 95% confidence intervals and examine the associated risk factors of diabetes prevalence among older adults. RESULTS The findings of the study indicate that the overall prevalence of diabetes among the study participants was found to be 12.4% which was significantly higher in urban areas (19%) compare to rural areas (6%). The socio-economic and bio-demographic factors like educational status, richest background family, marital status, obesity, and family history of diabetes were significantly associated with higher risks of diabetes prevalence among the older adult population in West Bengal. The risks of diabetes in the richest adult people were significantly higher than in the poorest adult people (OR = 2.78; 95% CI: 1.974-3.917). The higher risks of diabetes mellitus among the richest wealthy people are because of lifestyle behavior, smoking, and tobacco consumption respectively. CONCLUSION The study needs to policy and awareness program to reduce economic inequality and prevention of diabetes care and treatment-seeking behavior, especially for the older adult population in West Bengal.
Collapse
Affiliation(s)
- Ujjwal Das
- Dept. of Geography in, Rajiv Gandhi University, Doimukh, Arunachal Pradesh India
- Dept. of Geography, Fakir Mohan University, Balasore, Odisha India
| | - Nishamani Kar
- Dept. of Geography in, Rajiv Gandhi University, Doimukh, Arunachal Pradesh India
| |
Collapse
|
6
|
Shaphe MA, Alshehri MM, Alfaifi B, Aljahni MA, Esht V, Malik S, Bautista MJ, Alqahtani AS, Ahmad A, Khan A, Aafreen A, Khan AR. Assessment of Risk Factors and the Relationship between Hypothyroidism with Hypertension in Diabetes Mellitus Patients: A Cross-Sectional Community-Based Study. J Pers Med 2023; 13:1231. [PMID: 37623480 PMCID: PMC10455546 DOI: 10.3390/jpm13081231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/13/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: hypertension (HTN) and diabetes mellitus (DM) represent two widely noncommunicable diseases that are prevalent globally, and they often correlate with chronic health issues. There has been an acknowledged connection between diabetes, hypertension, and hypothyroidism for quite some time. However, the extent of thyroid dysfunction among the diabetic population is not uniform and significantly differs across different research studies. This study was conducted with the objective of identifying the risk factors associated with hypothyroidism as well as assessing the relationship between hypothyroidism and hypertension in patients with diabetes. (2) Materials and Methods: Participants aged 18 years and above were included in this study, while pregnant women were excluded. Trained health professionals measured sociodemographic, behavioural, food practices, and anthropometric information about the participants. Each respondent sought medical advice regarding their health, and a face-to-face interview enabled them to express concern about the likelihood of being diagnosed with diabetes mellitus and hypertension. (3) Results: The study encompassed 640 participants, with an average age of 49.20 ± 13.0 years. Among these participants, 65.5% were female, and 34.5% were male. Of the total, 31.25% were diagnosed with diabetes mellitus, and 18.75% had hypertension. Interestingly, co-occurrence of both conditions was observed in 9.68% of the population. A comparison of thyroid function and indicators of blood sugar levels yielded consistent results across the different patient groups. Specifically, for diabetes mellitus (DM) patients, the average levels were 3.4 ± 9.8 pg/mL for fT3, 0.9 ± 0.7 ng/dL for fT4, 3.3 ± 6.2 μiU/mL for TSH, 153.1 ± 68.0 mg/dL for fasting plasma glucose (FPG), 213.2 ± 97.2 mg/dL for postprandial glucose (PPG), and 8.3 ± 3.2% for HbA1c. (4) Conclusion: It is concluded that patients with hypertension had a significant prevalence of diabetes mellitus. Subclinical hypothyroid subjects must be frequently screened for hypertension. Of 120 individuals with hypertension, 45 (37.5%) were also diagnosed with diabetes. This co-occurrence was significantly higher in subjects aged over 50 years (26.7%), in the lower socio-economic class (18.5%), and among those who were married (14.7%). Additionally, patients with hypertension exhibited a high prevalence of diabetes across different educational backgrounds and occupations, with the highest prevalence among postgraduates (37.5%) and professionals (24.0%), respectively. These findings highlight the need for an integrated approach to the management of hypertension and diabetes, particularly in high-risk demographics.
Collapse
Affiliation(s)
- Mohammad Abu Shaphe
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Mohammed M. Alshehri
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Bushra Alfaifi
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Mohammed A Aljahni
- Physical Education Department, Jazan University, Jazan 45142, Saudi Arabia;
| | - Vandana Esht
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Shazia Malik
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Marissa J Bautista
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia; (M.A.S.); (M.M.A.); (B.A.); (V.E.); (S.M.); (M.J.B.)
| | - Abdulfattah S. Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ausaf Ahmad
- Department of Community Medicine, IIMS&R, Integral University, Lucknow 226026, India;
| | - Ashfaque Khan
- Department of Physiotherapy, Integral University, Lucknow 226026, India; (A.K.); (A.A.)
| | - Aafreen Aafreen
- Department of Physiotherapy, Integral University, Lucknow 226026, India; (A.K.); (A.A.)
| | - Abdur Raheem Khan
- Department of Physiotherapy, Integral University, Lucknow 226026, India; (A.K.); (A.A.)
| |
Collapse
|
7
|
Khatun MM, Rahman M, Islam MJ, Haque SE, Adam IF, Chau Duc NH, Sarkar P, Haque MN, Islam MR. Socio-economic inequalities in undiagnosed, untreated, and uncontrolled diabetes mellitus in Bangladesh: is there a gender difference? Public Health 2023; 218:1-11. [PMID: 36933353 DOI: 10.1016/j.puhe.2023.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/13/2022] [Accepted: 01/31/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES We aimed to determine: (1) the prevalence and socio-economic distribution of undiagnosed, untreated, and uncontrolled diabetes mellitus (DM); (2) the relationship between socio-economic status (SES) and undiagnosed, untreated, and uncontrolled DM; and (3) if this relationship is mediated by gender. STUDY DESIGN Cross-sectional nationally representative household-based survey. METHODS We used data from the Bangladesh Demographic Health Survey from 2017 to 18. Our findings were based on the responses of 12,144 individuals aged 18 years and older. As a measure of SES, we focused on standard of living (hereinafter referred to as wealth). The study's outcome variables were prevalence of total (diagnosed + undiagnosed), undiagnosed, untreated, and uncontrolled DM. We used three regression-based approaches-adjusted odds ratio, relative inequality index, and slope inequality index-to assess different aspects of SES differences in the prevalence of total, undiagnosed, untreated, and uncontrolled DM. We used logistic regression analysis to look at the adjusted association between SES and the outcomes after gender stratification to see whether gender status moderates the association between SES and the targeted outcomes. RESULTS In our sample analysis, the age-adjusted prevalence of total, undiagnosed, untreated, and uncontrolled DM was 9.1%, 61.4%, 64.7%, and 72.1%, respectively. Females had a higher prevalence of DM and undiagnosed, untreated, and uncontrolled DM than males. When compared to people in the poor SES group, people in the rich and middle SES groups had 2.60 times (95% confidence interval [CI] 2.05-3.29) and 1.47 times (95% CI 1.18-1.83) higher chance of developing DM. When compared to individuals in the poor SES group, those in the rich SES groups were 0.50 (95% CI 0.33-0.77) and 0.55 times (95% CI 0.36-0.85) less likely to have undiagnosed and untreated DM. CONCLUSIONS In Bangladesh, rich SES groups were more likely than poor SES groups to have DM, whereas poor SES groups with DM were less likely than rich SES groups to be aware of their disease and obtain treatment. The government and other concerned parties are urged by this study to pay more attention to developing suitable policy measures to reduce the risk of DM, particularly among rich SES groups, as well as targeted efforts to screen for and diagnose DM in socio-economically disadvantaged groups.
Collapse
Affiliation(s)
- M M Khatun
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
| | - M Rahman
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh.
| | - M J Islam
- Griffith Criminology Institute, Griffith University, Mount Gravatt, QLD 4122, Australia
| | - S E Haque
- Uchicago Research Bangladesh, Bangladesh
| | - I F Adam
- Faculty of Public Health, University of Khartoum, Sudan
| | - N H Chau Duc
- Hue University of Medicine and Pharmacy, Hue University, Viet nam
| | - P Sarkar
- Dr. Wazed Research and Training Institute, Begum Rokeya University, Rangpur, Bangladesh
| | - M N Haque
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
| | - M R Islam
- Department of Population Science and Human Resource Development University of Rajshahi, Rajshahi 6205, Bangladesh
| |
Collapse
|
8
|
Jayant SS, Gupta R, Rastogi A, Sachdeva N, Ram S, Dutta P, Bhansali A, Bhadada SK. Incidence and predictors of metabolic syndrome in Asian-Indians: a 10-year population-based prospective cohort study. Int J Diabetes Dev Ctries 2023:1-7. [PMID: 36777473 PMCID: PMC9903260 DOI: 10.1007/s13410-023-01169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/05/2023] [Indexed: 02/10/2023] Open
Abstract
Background Metabolic syndrome represents aggregation of risk factors associated with an increased risk of developing type 2 diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD). Assessing its incidence is an effective way for estimating the future burden of DM and ASCVD and understanding their secular trends and effect of public health measures on halting the evolution of risk factors. The present study aimed to estimate the incidence of metabolic syndrome and its predictors using a population-based cohort. Methods A subset of Chandigarh Urban Diabetes Study cohort (n = 1023) without diabetes or metabolic syndrome was prospectively evaluated after a mean of 10.7 years. Metabolic syndrome was defined as per International Diabetes Federation criteria and diabetes as per American Diabetes Association standards. The incidence was calculated in 1000 person years, and multivariate logistic regression was used to estimate the strength of association between incident metabolic syndrome and risk factors. Results In the followed-up individuals (n = 303), incidence of metabolic syndrome was 32.1 per 1000 person years (95% CI 26.3-38.7 per 1000 person years). Amongst those developing metabolic syndrome, ≥4 components were present in 52% individuals, with low HDL-C being the most common abnormality. Those with metabolic syndrome had a five-time higher risk of diabetes (OR: 4.94; 95% CI: 2.27-9.96; p < 0.001) and a threefold higher risk of hypertension (OR: 2.67; 95% CI: 1.30-5.48; p = 0.006). Conclusion Asian-Indians have a high incidence rate of metabolic syndrome, which is associated with sedentary lifestyle and consequent central obesity.
Collapse
Affiliation(s)
- Satyam Singh Jayant
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Rahul Gupta
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Ashu Rastogi
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Naresh Sachdeva
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Sant Ram
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pinaki Dutta
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Anil Bhansali
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Diabetes and Metabolism, Postgraduate Institute of Medical Education and Research (PGIMER), 8, Nehru Extension Block, Chandigarh, 160012 India
| |
Collapse
|
9
|
Li Y, Jiang Y, Lin J, Wang D, Wang C, Wang F. Prevalence and associated factors of diabetes mellitus among individuals aged 18 years and above in Xiaoshan District, China, 2018: a community-based cross-sectional study. BMJ Open 2022; 12:e049754. [PMID: 35296469 PMCID: PMC8928303 DOI: 10.1136/bmjopen-2021-049754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE With the rapid development of the Chinese economy, Xiaoshan District, Zhejiang Province has experienced urbanisation, population ageing and significant lifestyle changes, so diabetes mellitus (DM) has attracted more attention. This study aimed to evaluate the prevalence of DM and its risk factors among individuals aged 18 years and above in the district. STUDY DESIGN AND METHODS A community-based cross-sectional study was carried out in Xiaoshan, China from 1 March to 31 August 2018. A multistage sampling method was used. Sociodemographic and behavioural characteristics were collected using a combination of centralised surveys and household surveys. Anthropometric parameters were measured with standardised techniques and calibrated equipment. Venous blood samples were obtained after at least 8 hours of fasting to determine the level of fasting blood glucose (FBG) and blood lipids. A standard 2-hour 75 g oral glucose tolerance test was also given if 6.1 mmol/L≤FBG<7.0 mmol/L. Univariate and multivariate logistic regression analyses were used to assess the associated factors of DM. RESULTS The overall prevalence of DM was 12.47%, and the proportion of previously undiagnosed DM (UDM) was 48.66%. The prevalence of pre-diabetes was 10.92%. Age, family history of DM (FHDM), obesity, abdominal obesity, systolic blood pressure (SBP), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) were significantly associated with DM. CONCLUSIONS This study found a high prevalence of DM and pre-diabetes, especially a high prevalence of UDM among adults. The associated risk factors identified for DM were age, FHDM, obesity, abdominal obesity, SBP, TG and HDL-C.
Collapse
Affiliation(s)
- Yurong Li
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuanyuan Jiang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Junying Lin
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Dongfei Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Chunli Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Fenjuan Wang
- Zhejiang Provincial Health Bureau, Xiaoshan District Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| |
Collapse
|
10
|
Jayant SS, Gupta R, Rastogi A, Agrawal K, Sachdeva N, Ram S, Dutta P, Bhadada SK, Bhansali A. Abdominal obesity and incident cardio-metabolic disorders in Asian-Indians: A 10-years prospective cohort study. Diabetes Metab Syndr 2022; 16:102418. [PMID: 35123378 DOI: 10.1016/j.dsx.2022.102418] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS To estimate the strength of association between abdominal obesity and incident cardio-metabolic diseases. METHODS A subset of Chandigarh Urban Diabetes study cohort (n = 543) was followed after a mean of 10.7 years for development of diabetes, prediabetes, dysglycaemia (either prediabetes or diabetes), hypertension and atherosclerotic cardiovascular disease (ASCVD). Diabetes and prediabetes were defined as per American Diabetes Association consulting group criteria, hypertension as blood pressure of ≥140/90 mmHg and ASCVD after review of medical records. Abdominal obesity was defined as waist circumference of ≥80 cm and ≥90 cm in females and males, respectively. RESULTS As compared to non-obese (n = 209), abdominally obese individuals (n = 334) had a higher risk of diabetes [RR:1.82(1.28-2.57)], prediabetes [RR:1.40(1.05-1.85)], dysglycaemia [ RR:1.38(1.07-1.78)], hypertension [RR: 1.84(1.30-2.59)] and ASCVD [RR:2.12(1.02-4.4)]. The optimal cut-off of waist circumference for detecting incident diabetes, hypertension and ASCVD in females was 88 cm, 85 cm and 91 cm, respectively; while in males it was 90 cm, 87 cm and 94 cm, respectively. CONCLUSION In Asian-Indians, abdominal obesity as defined by waist circumference of ≥90 cm and ≥80 cm in males and females, respectively is associated with a twofold higher risk of diabetes, hypertension and ASCVD. In addition, the current-cut-offs of waist circumference to define abdominal obesity need reconsideration to optimally identify individuals at a higher risk of cardio-metabolic diseases. However, a high attrition rate represents a major limitation.
Collapse
Affiliation(s)
- Satyam Singh Jayant
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rahul Gupta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashu Rastogi
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - Kanhaiya Agrawal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sant Ram
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Pinaki Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Anil Bhansali
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| |
Collapse
|
11
|
Atal S, Joshi R, Misra S, Fatima Z, Sharma S, Balakrishnan S, Singh P. Patterns of drug therapy, glycemic control, and predictors of escalation - non-escalation of treatment among diabetes outpatients at a tertiary care center. J Basic Clin Physiol Pharmacol 2021; 33:803-814. [PMID: 34449177 DOI: 10.1515/jbcpp-2021-0189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The study was conducted to assess patterns of prescribed drug therapy and clinical predictors of need for therapy escalation in outpatients with diabetes mellitus (DM). METHODS This was a prospective cohort study, conducted at an apex tertiary care teaching hospital in central India for a period of 18 months. The demographic, clinical, and treatment details on the baseline and follow up visits were collected from the patients' prescription charts. Glycemic control, adherence, pill burdens along with pattern of antidiabetic therapy escalation, and deescalations were analyzed. RESULTS A total of 1,711 prescriptions of 925 patients of diabetes with a mean age of 53.81 ± 10.42 years and duration of disease of 9.15 ± 6.3 years were analyzed. Approximately half of the patients (n=450) came for ≥1 follow up visits. Hypertension (59.35%) was the most common comorbidity followed by dyslipidemia and hypothyroidism. The mean total daily drugs and pills per prescription were 4.03 ± 1.71 and 4.17 ± 1.38, respectively. Metformin (30.42%) followed by sulphonylureas (SUs) (21.39%) constituted majority of the AHA's and dual and triple drug therapy regimens were most commonly prescribed. There were improvements in HbA1c, fasting/postprandial/random blood sugar (FBS/PPBS/RBS) as well as adherence to medication, diet, and exercise in the follow up visits. Among patients with follow ups, therapy escalations were found in 31.11% patients, among whom dose was increased in 12.44% and drug was added in 17.28%. Apart from Hb1Ac, FBS, and PPBS levels (p<0.001), characteristics such as age, BMI, duration of diagnosed diabetes, presence of hypertension and dyslipidemia, and daily pill burdens were found to be significantly higher in the therapy escalation group (p<0.05). Inadequate medication adherence increased the relative risk (RR) of therapy escalation by almost two times. CONCLUSIONS Disease and therapy patterns are reflective of diabetes care as expected at a tertiary care center. Higher BMI, age, pill burden, duration of diabetes, presence of comorbidities, and poor medication adherence may be the predictors of therapy escalation independent of glycemic control and such patients should be more closely monitored.
Collapse
Affiliation(s)
- Shubham Atal
- Department of Pharmacology, AIIMS Bhopal, Bhopal, India
| | - Rajnish Joshi
- Department of General Medicine, AIIMS Bhopal, Bhopal, India
| | - Saurav Misra
- Department of Pharmacology, AIIMS Bhopal, Bhopal, India
| | - Zeenat Fatima
- Department of Pharmacology, AIIMS Bhopal, Bhopal, India
| | - Swati Sharma
- Department of Pharmacology, AIIMS Bhopal, Bhopal, India
| | | | - Pooja Singh
- Department of Pharmacology, R.N.T. Medical College, Udaipur, India
| |
Collapse
|
12
|
Deo KB, Kulkarni AA, Kumar-M P, Krishnamurthy G, Shenvi S, Rana SS, Kapoor R, Gupta R. Impact of diabetes mellitus on morbidity and survival after pancreaticoduodenectomy for malignancy. Ann Hepatobiliary Pancreat Surg 2021; 25:230-241. [PMID: 34053926 PMCID: PMC8180397 DOI: 10.14701/ahbps.2021.25.2.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/17/2021] [Accepted: 02/01/2021] [Indexed: 11/22/2022] Open
Abstract
Backgrounds/Aims Diabetes mellitus (DM) is a known risk factor for morbidity, length of hospital stay, or mortality after surgery, however, its impact on postoperative course and long-term survival after pancreaticoduodenectomy (PD) is not clear. Methods This is a retrospective analysis of prospectively maintained database of 141 patients with periampullary and pancreatic head adenocarcinoma operated between January 2001 and March 2019. Clinico-pathological records and follow-up data were retrieved and analyzed. Cumulative hazard was computed for comparing the survival between DM and non-DM. Results DM was present in 31/141 (21.9%) patients, while 16/31 (51.6%). were new-onset DM (NODM). Tumor size, lymphovascular & perineural invasion, type of surgery, lymph node positivity and R0 resection rate were comparable between diabetic and non-diabetic. There was no significant difference in postoperative pancreatic fistula, delayed gastric emptying, infectious complication, hospital stay and mortality between DM and nondiabetics. Patients with DM had worse survival at 3 years (OS: HR, 3.11 [1.43-6.76] p=0.004, DFS: HR, 2.61 [1.23-5.53] p=0.01) and 5 years (OS: HR, 3.32 [1.46-7.53] p=0.004, DFS: HR, 2.87 [1.29-6.41] p=0.009). On multivariate analysis, DM (3 year OS: HR, 2.61 [1.14-5.98] p=0.022, DFS: HR, 2.19; p=0.058) (5 year OS: HR, 2.55; p=0.04, DFS: HR, 2.25; p=0.068) and pylorus resecting surgery were significantly associated with worse survival at 3 and 5 years. Conclusions Preoperative DM has no significant effect on postoperative course but has negative impact on 3-year and 5-year OS and DFS after PD for pancreatic and periampullary adenocarcinoma.
Collapse
Affiliation(s)
- Kunal Bikram Deo
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.,Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Aditya Atul Kulkarni
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.,Department of Surgical Gastroenterology, D Y Patil Medical College, Pune, India
| | - Praveen Kumar-M
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Gautham Krishnamurthy
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.,Department of Surgical Gastroenterology, SRM Institutes for Medical Science, Chennai, India
| | - Sunil Shenvi
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.,Department of Liver Transplantation and Hepatobiliary Surgery, Gleneagles Global Hospital, Bangalore, India
| | - Surinder Singh Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rakesh Kapoor
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rajesh Gupta
- Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| |
Collapse
|
13
|
Ray T, Singh A, Dhiman B. Association between risk factors of common noncommunicable diseases (diabetes, hypertension, and cardiovascular diseases) and sociodemographic factors in young adult women. Indian J Community Med 2021; 46:748-751. [PMID: 35068749 PMCID: PMC8729284 DOI: 10.4103/ijcm.ijcm_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/09/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Objectives: Settings and Design: Materials and Methods: Results: Conclusion:
Collapse
|
14
|
Kumar S, Anand A, Nagarathna R, Kaur N, Sivapuram MS, Pannu V, Pal DK, Malik N, Singh AK, Nagendra HR. Prevalence of prediabetes, and diabetes in Chandigarh and Panchkula region based on glycated haemoglobin and Indian diabetes risk score. Endocrinol Diabetes Metab 2021; 4:e00162. [PMID: 33532605 PMCID: PMC7831224 DOI: 10.1002/edm2.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/17/2020] [Indexed: 01/12/2023] Open
Abstract
There is a rapid increase in the prevalence of diabetes in India. We wanted to review the status of prediabetes and diabetes in the combined population of Chandigarh and Panchkula region based on both Indian Diabetes Risk Score (IDRS) and Glycated Haemoglobin (HbA1c). A total of 1215 subjects were recruited during the screening process, out of which 444 i subjects have been analysed for the current study on the basis of high risk for IDRS (≥60) and their known diabetes status. This study included 431 subjects having high risk for IDRS (≥60) and 13 known subjects with diabetes (IDRS < 60) which were further analysed for biochemical and anthropometric parameters. The prevalence of diabetes was found to be 12.67% and prediabetes 11.69% in the combined population of Chandigarh and Panchkula. There was an increased level of fasting blood glucose (183.12 ± 68.61), postprandial blood glucose (262.57 ± 96.92), triglyceride (193.84 ± 119.88), very low-density lipoprotein (VLDL) (34.87 ± 15.42) and High Density Lipoprotein(HDL) (4.61 ± 1.39) in the said diabetes population. Mean HDL was found to be decreased in subjects having diabetes. Glucose-induced lipid intolerance study revealed significant alteration in triglyceride, HDL and VLDL. The study has revealed that high prevalence of diabetes in the sampled population when compared with the national average of 8.8%.
Collapse
Affiliation(s)
- Saurabh Kumar
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | - Akshay Anand
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | | | - Navneet Kaur
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
- Department of Physical EducationPanjab UniversityChandigarhIndia
| | - Madhava Sai Sivapuram
- Department of General MedicineDr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research FoundationChinna‐AvutapalliIndia
| | - Viraaj Pannu
- Government Medical College and Hospital Sector‐32ChandigarhIndia
| | - Deepak Kumar Pal
- Neuroscience Research LabDepartment of NeurologyPostgraduate Institute of Medical Education and Research (PGIMER)ChandigarhIndia
| | - Neeru Malik
- Dev Samaj College of EducationChandigarhIndia
| | - Amit Kumar Singh
- Swami Vivekananda Yoga Anusandhana Samsthana (S‐VYASA)BengaluruIndia
| | | |
Collapse
|
15
|
Ganie MA, Sahar T, Rashid A, Baba MS, Ahmad N, Bhat H, Wani IA, Shah ZA. Prevalence of diabetes and prediabetes in tribal population of Kashmir: Lessons for the future. Diabetes Res Clin Pract 2020; 169:108457. [PMID: 32979420 DOI: 10.1016/j.diabres.2020.108457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 09/03/2020] [Accepted: 09/15/2020] [Indexed: 11/25/2022]
Abstract
AIMS Considering a surge in the incidence of Diabetes mellitus (DM) across all ethnic groups and lack of any representative data from the tribal communities of Jammu and Kashmir, the present study aimed to assess the prevalence of DM and prediabetes in them. METHODS Subjects were recruited from five districts of Kashmir valley using multistage cluster sampling by probability proportional to size (PPS) technique. Data collection included recording of socio-demographic, medical facts, assessment of anthropometric parameters and biochemical evaluation HbA1c and random blood glucose measurements as per the American Diabetes Association (ADA) criteria were used for diagnosis of DM. RESULTS A total of 6808 subjects were recruited in this study including 2872 (42%) men and 3936 (58%) women with mean age of 39.60 ± 20.19 years and 35.17 ± 16.70 years, respectively. Around 8.60% subjects were obese, 38.9% were found to be hypertensive, 73% had dyslipidemia and 3.75% had metabolic syndrome. About 1.26% (0.5% males and 0.9% females) had DM and 11.64% had prediabetes based on HbA1c cut offs. Increasing age, body mass index and family history portend significant risk factors while smoking and sedentary lifestyle increased the risk marginally. CONCLUSIONS Although the prevalence of DM among tribals of Kashmir valley is lower than general population, the higher prediabetes to DM ratio may indicate a future trend of increasing DM prevalence in this disadvantageous subpopulation.
Collapse
Affiliation(s)
- Mohd Ashraf Ganie
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India.
| | - Tajali Sahar
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Aafia Rashid
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Mohd Saleem Baba
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Nisar Ahmad
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Hilal Bhat
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Imtiyaz Ahmad Wani
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Zafar Amin Shah
- Department of Immunology and Molecular Medicine, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| |
Collapse
|
16
|
Atre S, Deshmukh S, Kulkarni M. Prevalence of type 2 diabetes mellitus (T2DM) in India: A systematic review (1994-2018). Diabetes Metab Syndr 2020; 14:897-906. [PMID: 32570014 DOI: 10.1016/j.dsx.2020.05.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 02/01/2023]
Abstract
AIM To conduct a systematic and critical review of published studies on prevalence of Type 2 diabetes mellitus (T2DM) in urban and rural areas of India. METHODS We conducted a literature search in PubMed, EMBASE and Web of Science using the terms 'prevalence', 'Type 2 diabetes, 'India', 'urban' and 'rural' for English language articles published during January 1994-December 2018. We selected articles that reported the results of original studies that randomly sampled adults aged 15-80 years, and which reported T2DM prevalence based on the actual examination of blood samples. RESULTS Of 1751 articles screened by titles and abstracts, 37 fulfilled our inclusion criteria. Majority (28 of 37; 76%) of studies were from South India, especially from the states of Tamil Nadu, Andhra Pradesh, Kerala and Karnataka. The prevalence of T2DM showed a wide range from 1.9% to 25.2%. Only 11 studies covering 24 regions separately reported the data by urban or rural location. Albeit inconsistent, 17 studies reported prevalence of T2DM by age group. CONCLUSION In this systematic review, we show that there remains an ambiguity about the actual prevalence of T2DM from India due to several factors. The findings underscore a strong need for having periodic regional surveillance involving appropriate epidemiological methods.
Collapse
Affiliation(s)
- Sachin Atre
- Dr. D.Y. Patil Medical College Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth Pimpri, Pune 411018, India.
| | - Sona Deshmukh
- Byramjee-Jeejeebhoy Medical College, Clinical Research Site, Pune 411001, India
| | - Manjusha Kulkarni
- Environmental Health and Safety, Kent State University, Kent, OH, 44242, USA
| |
Collapse
|
17
|
Sharma K, Battu P, Anand A, Nagarathna R, Kaur N, Malik N, Singh A, Nagendra HR. Management of Type II Diabetes by Modulating the Modifiable Risk Factors: A Future Roadmap for Prevention of Cerebrovascular Complications. Ann Neurosci 2020; 27:266-272. [PMID: 34556967 PMCID: PMC8455006 DOI: 10.1177/09727531211000041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Indian Diabetes Risk Score (IDRS) is a screening tool for quantifying the risk of diabetes mellitus (DM) development in the Indian population. The present study has evaluated the level of risk of developing DM in Chandigarh and Panchkula based on the IDRS score. Methods: As a part of a national diabetes control trial funded by the Ministry of Health and Family Welfare (MoHFW) and the Ministry of AYUSH, Government of India, 1,916 participants from the Chandigarh and Panchkula regions were assessed for the risk of developing DM. Risk assessment was done on the basis of the IDRS score which includes age, family history, waist circumference, and physical activity as its contributing factors. Participants with an IDRS score <30 were in the low-risk category, those with 30 to 50 were in the moderate-risk category, and those with >60 were in the high-risk category for DM. Results: Out of the 1,916 screened respondents (59.86% females and 40.14% males), 894 participants (46.65%) were at a high risk for DM (IDRS >60), 764 (39.87%) were at a moderate risk (IDRS = 30–60), and 258 (13.46%) were at a low risk (IDRS <30). Waist circumference contributed to 35.90% of the high-risk category followed by age (19.67%) and physical activity (11.67%). Age and waist circumference also showed a strong correlation with the total IDRS score. Conclusion: The Chandigarh and Panchkula population showed a high tendency to develop DM based on the IDRS score. Modifiable risk factors such as waist circumference and physical activity were the major contributing factors. Apart from the modifiable risk factors, age was also another major contributing risk factor. Based on these outcomes, lifestyle modifications like yoga and exercise can be proposed for this population as a preventive approach to reduce the risk of developing DM and other associated cerebrovascular complications.
Collapse
Affiliation(s)
- Kanupriya Sharma
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,These contributed equally to this work
| | - Priya Battu
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,These contributed equally to this work
| | - Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Centre for Mind-Body Medicine, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.,Centre for Cognitive Sciences and Phenomenology, Panjab University, Chandigarh, India
| | - Raghuram Nagarathna
- VYASA Arogyadhama, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, Karnataka, India
| | - Navneet Kaur
- Department of Physical Education, Panjab University, Chandigarh, India
| | - Neeru Malik
- Dev Samaj College of Education, Chandigarh, India
| | - Amit Singh
- Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | | |
Collapse
|
18
|
Podder V, Srivastava V, Kumar S, Nagarathna R, Sivapuram MS, Kaur N, Sharma K, Singh AK, Malik N, Anand A, Nagendra HR. Prevalence and Awareness of Stroke and Other Comorbidities Associated with Diabetes in Northwest India. J Neurosci Rural Pract 2020; 11:467-473. [PMID: 32753814 PMCID: PMC7394624 DOI: 10.1055/s-0040-1709369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objectives
The main purpose of this study is to investigate the prevalence of comorbid conditions in diabetic, prediabetic, and nondiabetic individuals. Additionally, the current study examines the levels of awareness of those comorbidities among North Indian population.
Methods
As a part of a national study (Niyantrit Madhumeh Bharat [NMB] screening program), different comorbidity parameters were screened in the northern part of India between April and September 2017. There were 1,215 participants recruited in this study. Biochemical analyses of hemoglobin A1c (HbA1c) were conducted on the study subjects. Subsequently, the study subjects were divided into diabetic, prediabetic, and nondiabetic groups based on their HbA1c results.
Results
The study analysis reveals a higher prevalence of peripheral vascular disease (21.2%), ocular diseases (18%), and hypertension (13.4%) in diabetics with other comorbidities. Furthermore, the study found that a vast majority of the participants were unaware of the presence of hypertension (67.2%), dyslipidemia (84.5%), kidney disease (95.2%), peripheral vascular disease (34.5%), and stroke (95.1%).
Conclusion
The study concluded that in the northern India, the prevalence of multiple comorbid conditions, such as peripheral vascular disease and hypertension, is higher among diabetic population. Also, the level of awareness of diabetic comorbidities is surprisingly low, which has implications for policymakers, health practitioners, and educators of alternate medicine to increase awareness about diabetes, comorbid conditions, health risk, and possible solution at community and rural level, such as periodic screening programs in this population.
Collapse
Affiliation(s)
- Vivek Podder
- Department of General Medicine, Kamineni Institute of Medical Sciences, Narketpally, Telangana, India
| | - Vinod Srivastava
- Department of Social Work, University of Kentucky, Lexington, Kentucky, United States
| | - Saurabh Kumar
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Madhava Sai Sivapuram
- Department of General Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Chinna-Avutapalli, Krishna, Andhra Pradesh, India
| | - Navneet Kaur
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.,Department of Physical Education, Panjab University, Chandigarh, India
| | - Kanupriya Sharma
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | - Neeru Malik
- Department of Yoga, Dev Samaj College of Education, Panjab University, Chandigarh, India
| | - Akshay Anand
- Department of Neurology, Neuroscience Research Lab, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | |
Collapse
|
19
|
The Prevalence of Overweight, Obesity, Hypertension, and Diabetes in India: Analysis of the 2015-2016 National Family Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203987. [PMID: 31635366 PMCID: PMC6843936 DOI: 10.3390/ijerph16203987] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 02/06/2023]
Abstract
Overweight, obesity, hypertension, and diabetes increase the risk of non-communicable diseases and all-cause mortality worldwide. Previous studies have not determined the prevalence of these conditions/diseases throughout India. Therefore, this study was aimed to address this limitation. Data on these conditions/diseases among men and women aged ≥ 18 years were obtained from the fourth National Family Health Survey conducted throughout India between January 2015 and December 2016. The prevalence and prevalence rate per 100,000 population were calculated at the national level and by age group, sex, and type of residence for each state and union territory. The national prevalence of overweight, obesity, hypertension, and diabetes were 14.6%, 3.4%, 5.2%, and 7.1%, respectively. The highest prevalence of these conditions/diseases at the national level was seen among those aged 35–49 years (54 years for men), especially women living in urban areas. In India, 1 out of every 7, 29, 19, and 14 individuals at the national level had overweight, obesity, hypertension, and diabetes, respectively—between 2015 and 2016. These results are important for the healthcare system and government policies in the future. Moreover, targeted efforts are required to establish public health strategies for the prevention, management, and treatment of these conditions/diseases throughout India.
Collapse
|
20
|
Anderson P, Grills N, Singh R, Singh R, Evans RG, Sengupta P, Thrift AG. Prevalence of diabetes and pre-diabetes in rural Tehri Garhwal, India: influence of diagnostic method. BMC Public Health 2019; 19:817. [PMID: 31234815 PMCID: PMC6591826 DOI: 10.1186/s12889-019-7184-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/17/2019] [Indexed: 01/14/2023] Open
Abstract
Background There are few available data regarding the prevalence of diabetes in the sub-Himalayan region of India. The aim of this study was to determine the prevalence of pre-diabetes and diabetes in rural Garhwal based on glycosylated hemoglobin. Methods In a cross-sectional survey of 500 adults from five randomly selected villages in Chamba, a mountainous Tehri Garhwal district in Uttarakhand in north-west India, we determined the prevalence of diabetes (hemoglobin (Hb) A1c ≥ 6.5%) and pre-diabetes (5.7% ≤ HbA1c ≤ 6.4%). In a sub-sample of those diagnosed with diabetes or pre-diabetes (n = 140), fasting blood glucose (FBG, n = 117) or postprandial blood glucose (PBG, n = 23), and blood hemoglobin concentration, was measured at follow-up. Results Based on HbA1c, 10.0% had diabetes and 56.4% pre-diabetes. Of those diagnosed as diabetic by HbA1c, 10 of 16 (62.5%) were diagnosed as diabetic by FBG (> 125 mg/dL) or PBG (≥200 mg/dL). In those diagnosed as pre-diabetic by HbA1c, only 55 of 124 (44.4%) were diagnosed as pre-diabetic by FBG (100–125 mg/dL) or PBG (140–199 mg/dL). A large proportion of these 140 individuals (67.1%) were moderately to severely anemic (Hb < 11.4 mg/dL). The diagnostic gap for pre-diabetes between HbA1c and FBG/PBG was similar for the groups with and without moderate to severe anemia. Conclusions HbA1c and FBG/PBG have similar diagnostic performance for diabetes in this population. However, many individuals were diagnosed with pre-diabetes by HbA1c but not FBG/PBG. The relative excess diagnosis of pre-diabetes with HbA1c does not appear to be explained by anemia, an endemic condition in India. The prognostic significance of diagnosis of pre-diabetes by HbA1c but not FBG/PBG remains unknown, but merits investigation. Electronic supplementary material The online version of this article (10.1186/s12889-019-7184-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Pam Anderson
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Nathan Grills
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Rajesh Singh
- Garhwal Community Development and Welfare Society, Mussoorie Road, Chamba, India
| | - Rajkumari Singh
- Garhwal Community Development and Welfare Society, Mussoorie Road, Chamba, India
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia
| | | | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, 3800, Australia.
| |
Collapse
|
21
|
Biases in self-reported height and weight measurements and their effects on modeling health outcomes. SSM Popul Health 2019; 7:100405. [PMID: 31193386 PMCID: PMC6527819 DOI: 10.1016/j.ssmph.2019.100405] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/27/2019] [Accepted: 04/29/2019] [Indexed: 11/21/2022] Open
Abstract
Self-reported anthropometrics are often used as proxies for measured anthropometrics, but research has shown that heights and weights are often misreported. Using the Study on global AGEing and adult health, I analyze misreporting patterns of height, weight, and BMI in China, India, Russia, and South Africa. Adjustments of self-reported heights and weights using demographic, social, and anthropometric characteristics are evaluated and found to be useful in studying the distribution of anthropometrics within a population. Measured, self-reported, and adjusted BMI are then compared in logistic regression models on the reporting of health outcomes, as well as the resulting accuracy of individual prediction. When BMI is used as a continuous variable in models of health outcomes, measured, self-reported, and adjusted BMI produce similar coefficient estimates, and so self-reported data would be a natural choice because of its accessibility and convenience. In other applications, such as models using categorical BMI and individual prediction using either continuous or categorical BMI, self-reported data in lieu of measured data might not be accurate enough, but adjustments could serve as a potential compromise. There is heterogeneity in height and weight reporting patterns. Adjustments can be useful in studying population-level distributions. Variants of continuous BMI produce similar results in models of health outcomes. Variants of categorical BMI should not be used in lieu of measured data. Measured BMI is better for individual prediction of health outcomes.
Collapse
|
22
|
Pei D, Gong Y, Kang H, Zhang C, Guo Q. Accurate and rapid screening model for potential diabetes mellitus. BMC Med Inform Decis Mak 2019; 19:41. [PMID: 30866905 PMCID: PMC6416888 DOI: 10.1186/s12911-019-0790-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/03/2019] [Indexed: 11/26/2022] Open
Abstract
Background Prediction or early diagnosis of diabetes is crucial for populations with high risk of diabetes. Methods In this study, we assessed the ability of five popular classifiers (J48, AdaboostM1, SMO, Bayes Net, and Naïve Bayes) to identify individuals with diabetes based on nine non-invasive and easily obtained clinical features, including age, gender, body mass index (BMI), hypertension, history of cardiovascular disease or stroke, family history of diabetes, physical activity, work stress, and salty food preference. A total of 4205 data entries were obtained from annual physical examination reports for adults in the Shengjing Hospital of China Medical University during January–April 2017. Weka data mining software was used to identify the best algorithm for diabetes classification. Results The results indicate that decision tree classifier J48 has the best performance (accuracy = 0.9503, precision = 0.950, recall = 0.950, F-measure = 0.948, and AUC = 0.964). The decision tree structure shows that age is the most significant feature, followed by family history of diabetes, work stress, BMI, salty food preference, physical activity, hypertension, gender, and history of cardiovascular disease or stroke. Conclusions Our study shows that decision tree analyses can be applied to screen individuals for early diabetes risk without the need for invasive tests. This procedure will be particularly useful in developing regions with high epidemiological risk and poor socioeconomic status, and enable clinical practitioners to rapidly screen patients for increased risk of diabetes. The key features in the tree structure could further facilitate diabetes prevention through targeted community interventions, which can potentially improve early diabetes diagnosis and reduce burdens on the healthcare system.
Collapse
Affiliation(s)
- Dongmei Pei
- Department of Family Medicine, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| | - Yang Gong
- University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Hong Kang
- University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Chengpu Zhang
- Department of Family Medicine, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| | - Qiyong Guo
- Department of radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China.
| |
Collapse
|
23
|
Pei D, Zhang C, Quan Y, Guo Q. Identification of Potential Type II Diabetes in a Chinese Population with a Sensitive Decision Tree Approach. J Diabetes Res 2019; 2019:4248218. [PMID: 30805372 PMCID: PMC6362481 DOI: 10.1155/2019/4248218] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/20/2018] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Diabetes mellitus is a chronic disease with a steadfast increase in prevalence. Due to the chronic course of the disease combining with devastating complications, this disorder could easily carry a financial burden. The early diagnosis of diabetes remains as one of the major challenges medical providers are facing, and the satisfactory screening tools or methods are still required, especially a population- or community-based tool. METHODS This is a retrospective cross-sectional study involving 15,323 subjects who underwent the annual check-up in the Department of Family Medicine of Shengjing Hospital of China Medical University from January 2017 to June 2017. With a strict data filtration, 10,436 records from the eligible participants were utilized to develop a prediction model using the J48 decision tree algorithm. Nine variables, including age, gender, body mass index (BMI), hypertension, history of cardiovascular disease or stroke, family history of diabetes, physical activity, work-related stress, and salty food preference, were considered. RESULTS The accuracy, precision, recall, and area under the receiver operating characteristic curve (AUC) value for identifying potential diabetes were 94.2%, 94.0%, 94.2%, and 94.8%, respectively. The structure of the decision tree shows that age is the most significant feature. The decision tree demonstrated that among those participants with age ≤ 49, 5497 participants (97%) of the individuals were identified as nondiabetic, while age > 49, 771 participants (50%) of the individuals were identified as nondiabetic. In the subgroup where people were 34 < age ≤ 49 and BMI ≥ 25, when with positive family history of diabetes, 89 (92%) out of 97 individuals were identified as diabetic and, when without family history of diabetes, 576 (58%) of the individuals were identified as nondiabetic. Work-related stress was identified as being associated with diabetes. In individuals with 34 < age ≤ 49 and BMI ≥ 25 and without family history of diabetes, 22 (51%) of the individuals with high work-related stress were identified as nondiabetic while 349 (88%) of the individuals with low or moderate work-related stress were identified as not having diabetes. CONCLUSIONS We proposed a classifier based on a decision tree which used nine features of patients which are easily obtained and noninvasive as predictor variables to identify potential incidents of diabetes. The classifier indicates that a decision tree analysis can be successfully applied to screen diabetes, which will support clinical practitioners for rapid diabetes identification. The model provides a means to target the prevention of diabetes which could reduce the burden on the health system through effective case management.
Collapse
Affiliation(s)
- Dongmei Pei
- Department of Family Medicine, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| | - Chengpu Zhang
- Department of Family Medicine, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| | - Yu Quan
- Department of Informatics, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| | - Qiyong Guo
- Department of Radiology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
24
|
Gyawali B, Hansen MRH, Povlsen MB, Neupane D, Andersen PK, McLachlan CS, Sandbæk A, Vaidya A, Kallestrup P. Awareness, prevalence, treatment, and control of type 2 diabetes in a semi-urban area of Nepal: Findings from a cross-sectional study conducted as a part of COBIN-D trial. PLoS One 2018; 13:e0206491. [PMID: 30388140 PMCID: PMC6214524 DOI: 10.1371/journal.pone.0206491] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 10/15/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Type 2 diabetes is an escalating public health problem in Nepal. The current study aims to assess the prevalence, associated factors, awareness, treatment, and control of type 2 diabetes in a semi-urban area of Nepal. METHODS A population-based cross-sectional survey was conducted including 2,310 adults aged 25 years or above from a semi-urban area of Lekhnath Municipality of Nepal, during October 2016 to April 2017 using the World Health Organization (WHO) STEPS approach. Data on demographics, behavioral risk factors, blood pressure, anthropometric measurements (weight, height, waist and hip circumference), and fasting blood glucose were collected by face-to-face interviews during a door-to-door visit. Participants were considered to have type 2 diabetes if they had previously been diagnosed by a physician and/or were on antidiabetic medications and/or had fasting blood glucose ≥ 7.0 mmol/L. Participants were classified as being aware of their diabetes conditions if they had earlier been told that they had type 2 diabetes. Treatment of diabetes among those aware was if participants received any kind of medication treatment or counseling, and control of diabetes among those treated was defined as fasting blood glucose level was <7.0 mmol/L. Odds Ratio (OR) with 95% Confidence Interval (CI) was used to determine the strength of association. RESULTS The prevalence of type 2 diabetes was 11.7% (95% CI: 10.5-13.1). Among type 2 diabetes participants, 65% were aware of their disease, 94% of those who were aware received treatment, and 21% of the treated subjects had their diabetes under control. Factors significantly associated with type 2 diabetes were older age (OR = 3.2 for age group 45-54 years, OR = 3.8 for age group 55-64 years), Janajati ethnicity (OR = 1.4), abdominal obesity (OR = 2.3), being overweight or obese (OR = 1.4), and hypertension (OR = 2.0), while protective factors included being a female (OR = 0.4), medium physical activity (OR = 0.3), high physical activity (OR = 0.2), and not having family history of diabetes (OR = 0.3). CONCLUSIONS The study revealed a high prevalence of type 2 diabetes among adults. Older age, male gender, Janajati ethnicity, abdominal obesity, overweight or obesity, hypertension, low physical activity, and family history of diabetes were associated with type 2 diabetes. Immediate public health and individual measures are warranted to reduce further burden of type 2 diabetes.
Collapse
Affiliation(s)
- Bishal Gyawali
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Martin Rune Hassan Hansen
- Department of Public Health, Aarhus University, Aarhus C, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Mia Buhl Povlsen
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Dinesh Neupane
- Department of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | | | | | - Annelli Sandbæk
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Abhinav Vaidya
- Department of Community Medicine, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal
| | - Per Kallestrup
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| |
Collapse
|
25
|
Dudeja P, Singh G, Gadekar T, Mukherji S. Performance of Indian Diabetes Risk Score (IDRS) as screening tool for diabetes in an urban slum. Med J Armed Forces India 2017; 73:123-128. [PMID: 28924311 PMCID: PMC5592265 DOI: 10.1016/j.mjafi.2016.08.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 08/16/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND India is diabetic capital of world, with maximum number of diabetic patients. There is large burden of undetected diabetic cases in community. There is increasing risk of diabetes in urban slum, because of illiteracy, lack of awareness, low socioeconomic status and unhealthy life style. Madras Diabetes Research Foundation (MDRF) has developed Indian Diabetes Risk Score (IDRS) to detect undiagnosed Type 2 diabetes. The aim of this article is to study the performance of IDRS as screening tool for undiagnosed cases of Type 2 diabetes and to find the prevalence of undiagnosed Type 2 diabetes in an urban slum. METHODS Screening for diabetes was carried out in an urban slum. The sample size was 155 (assumed prevalence of undiagnosed diabetes 9%). IDRS tool comprising of two modifiable (waist circumference, physical activity) and two non-modifiable risk factors (age, family history) for diabetes was used to assess the risk of diabetes anthropometry data was obtained. Conformation of diabetes was done using blood sugar levels on fasting venous sample. RESULTS Mean and SD for age of study subjects were 49.68 ± 14.80 years, BMI 26.60 ± 8.51 kg/m2, waist hip ratio (females) 0.87 ± 0.06 cm, waist hip ratio (males) 0.95 ± 0.06 cm, waist circumference (females) 89.99 ± 10.95 cm, waist circumference (males) 89.44 ± 10.9 cm. IDRS predicted the risk of diabetes mellitus with sensitivity of 95.12% and specificity of 28.95% in individuals with score >60. CONCLUSION IDRS can be used as an effective tool for screening undiagnosed diabetes in the community.
Collapse
Affiliation(s)
- Puja Dudeja
- Assistant Professor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - Gurpreet Singh
- Clinical Tutor, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - Tukaram Gadekar
- Resident, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| | - Sandip Mukherji
- Professor & Head, Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
| |
Collapse
|
26
|
Raman R, Ganesan S, Pal SS, Gella L, Kulothungan V, Sharma T. Incidence and Progression of Diabetic Retinopathy in Urban India: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS II), Report 1. Ophthalmic Epidemiol 2017; 24:294-302. [DOI: 10.1080/09286586.2017.1290257] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Suganeswari Ganesan
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Swakshyar Saumya Pal
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Laxmi Gella
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
- Elite School of Optometry, St. Thomas Mount, Chennai, Tamil Nadu, India
| | | | - Tarun Sharma
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| |
Collapse
|
27
|
Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Pal A, Prasad R, Saran R. Prevalence and risk factors of diabetes in a large community-based study in North India: results from a STEPS survey in Punjab, India. Diabetol Metab Syndr 2017; 9:8. [PMID: 28127405 PMCID: PMC5259959 DOI: 10.1186/s13098-017-0207-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 01/13/2017] [Indexed: 11/10/2022] Open
Abstract
AIMS India is the diabetes capital with home to 69.1 million people with DM, the second highest number of cases after China. Recent epidemiological evidence indicates a rising DM epidemic across all classes, both affluent and the poor in India. This article reports on the prevalence of diabetes and pre-diabetes in the North Indian state of Punjab as part of a large household NCD Risk Factor Survey. METHODS A household NCD STEPS survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) was assayed for blood parameters. RESULTS Overall prevalence of DM among the study participants was found out to be 8.3% (95% CI 7.3-9.4%) whereas prevalence of prediabetes was 6.3% (5.4-7.3%). Age group (45-69 years), marital status, hypertension, obesity and family history of DM were found to be the risk factors significantly associated with DM. Out of all persons with DM, only 18% were known case of DM or on treatment, among whom only about one-third had controlled blood glucose status. CONCLUSIONS The study reported high prevalence of diabetes, especially of undiagnosed cases amongst the adult population, most of whom have uncontrolled blood sugar levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up.
Collapse
Affiliation(s)
- Jaya Prasad Tripathy
- International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India
| | - J. S. Thakur
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gursimer Jeet
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sohan Chawla
- School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Jain
- Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnab Pal
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajendra Prasad
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajiv Saran
- Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI USA
| |
Collapse
|
28
|
Assessment of prescription adherence to the AACE guidelines and risk factors for type 2 diabetes in a South Indian tertiary care hospital. Int J Diabetes Dev Ctries 2016. [DOI: 10.1007/s13410-016-0527-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
29
|
Abstract
India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Type 2 diabetes mellitus in Asian Indian people is characterized by a young age of onset and occurrence at low levels of BMI. Available data also suggest that the susceptibility of Asian Indian people to the complications of diabetes mellitus differs from that of white populations. Management of this disease in India faces multiple challenges, such as low levels of awareness, paucity of trained medical and paramedical staff and unaffordability of medications and services. Novel interventions using readily available resources and technology promise to revolutionise the care of patients with diabetes mellitus in India. As many of these challenges are common to most developing countries of the world, the lessons learnt from India's experience with diabetes mellitus are likely to be of immense global relevance. In this Review, we discuss the epidemiology of diabetes mellitus and its complications in India and outline the advances made in the country to ensure adequate care. We make specific references to novel, cost-effective interventions, which might be of relevance to other low-income and middle-income countries of the world.
Collapse
Affiliation(s)
- Ranjit Unnikrishnan
- Madras Diabetes Research Foundation &Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre of Education, No. 6 Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation &Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre of Education, No. 6 Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation &Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre of Education, No. 6 Conran Smith Road, Gopalapuram, Chennai, 600 086, India
| |
Collapse
|
30
|
Deepa M, Grace M, Binukumar B, Pradeepa R, Roopa S, Khan HM, Fatmi Z, Kadir MM, Naeem I, Ajay VS, Anjana RM, Ali MK, Prabhakaran D, Tandon N, Mohan V, Narayan KMV. 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; 110:172-82. [PMID: 26432412 PMCID: PMC4752677 DOI: 10.1016/j.diabres.2015.09.005] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 08/21/2015] [Accepted: 09/04/2015] [Indexed: 01/06/2023]
Abstract
AIM To estimate the prevalence of, and assess factors associated with, diabetes and prediabetes in three South Asian cities. METHODS Using a multi-stage cluster random sample representative of each city, 16,288 subjects aged ≥20 years (Chennai: 6906, Delhi: 5365 and Karachi: 4017) were recruited to the Centre for cArdio-metabolic Risk Reduction in South-Asia (CARRS) Study. Fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) were measured in 13720 subjects. Prediabetes was defined as FPG 100-125 mg/dl (5.6-6.9 mmol/l) and/or HbA1c 5.7-6.4% (39-46 mmol/mol) and diabetes as self-report and/or drug treatment for diabetes and/or FPG≥126 mg/dl (≥7.0 mmol/l) and/or HbA1c≥6.5% (48 mmol/mol). We assessed factors associated with diabetes and prediabetes using polytomous logistic regression models. RESULTS Overall 47.3-73.1% of the population had either diabetes or prediabetes: Chennai 60.7% [95%CI: 59.0-62.4%] (diabetes - 22.8% [21.5-24.1%], prediabetes - 37.9% [36.1-39.7%]); Delhi 72.7% [70.6-74.9%] (diabetes - 25.2% [23.6-26.8%], prediabetes - 47.6% [45.6-49.5%]); and Karachi 47.4% [45.7-49.1%]; (diabetes - 16.3% [15.2-17.3%], prediabetes - 31.1% [29.5-32.8%], respectively). Proportions of self-reported diabetes were 55.1%, 39.0%, and 48.0% in Chennai, Delhi, and Karachi, respectively. City, age, family history of diabetes, generalized obesity, abdominal obesity, body fat, high cholesterol, high triglyceride, and low HDL cholesterol levels were each independently associated with prediabetes, while the same factors plus waist-to-height ratio and hypertension were associated with diabetes. CONCLUSION Six in ten adults in large South Asian cities have either diabetes or prediabetes. These data call for urgent action to prevent diabetes in South Asia.
Collapse
Affiliation(s)
- Mohan Deepa
- Madras Diabetes Research Foundation (MDRF), Chennai, India.
| | - Mundu Grace
- Public Health Foundation of India (PHFI) & Centre for Chronic Disease Control (CCDC), New Delhi, India
| | | | | | - Shivashankar Roopa
- Public Health Foundation of India (PHFI) & Centre for Chronic Disease Control (CCDC), New Delhi, India
| | | | | | | | | | - Vamadevan S Ajay
- Public Health Foundation of India (PHFI) & Centre for Chronic Disease Control (CCDC), New Delhi, India
| | | | | | - Dorairaj Prabhakaran
- Public Health Foundation of India (PHFI) & Centre for Chronic Disease Control (CCDC), New Delhi, India
| | - Nikhil Tandon
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | | | | |
Collapse
|
31
|
Trends in diabetes epidemiology in Indian population in spite of regional disparities: a systemic review. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-014-0269-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
|
32
|
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; 4:010404. [PMID: 24976963 PMCID: PMC4073245 DOI: 10.7189/jogh.04.010404] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diabetes mellitus is one of the diseases considered to be the main constituents of the global non-communicable disease (NCD) pandemic. Despite the large impact that NCDs are predicted to have, particularly in developing countries, estimates of disease burden are sparse and inconsistent. This systematic review transparently estimates prevalence of type 2 diabetes mellitus in Southern Asia, its association with urbanization and provides insight into the policy challenges facing the region. METHODS The databases Medline and PubMed were searched for population-based studies providing estimates of diabetes prevalence in the Southern Asia region. Studies using WHO diagnostic criteria of fasting plasma glucose (FPG) ≥7.0mmol/L and/or 2h-plasma glucose (2hPG) ≥11.1mmol/L were included. Data from eligible studies was extracted into bubble graphs, and trend lines were applied to UNPD figures to estimate age-specific prevalence in the regional population. Estimates specific to sex, area of residency, and diagnostic method were compared and trends analysed. RESULTS A total of 151 age-specific prevalence estimates were extracted from 39 studies. Diabetes prevalence was estimated to be 7.47% for 2005 and 7.60% for 2010. Prevalence was strongly associated with increased age, male gender and urban residency (P < 0.001). CONCLUSION Diabetes prevalence in Southern Asia is high and predicted to increase in the future as life expectancy rises and the region continues to urbanise. Countries in this region need to improve NCD surveillance and monitoring so policies can be informed with the best evidence. Programs for prevention need to be put in place, and health system capacity and access needs to be assessed and increased to deal with the predicted rise in NCD prevalence.
Collapse
Affiliation(s)
- Arsalan Cheema
- Centre for Population Health Sciences and the World Health Organization's Collaboration Centre for Population Health Research and Training, The University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - Davies Adeloye
- Centre for Population Health Sciences and the World Health Organization's Collaboration Centre for Population Health Research and Training, The University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - Simrita Sidhu
- Centre for Population Health Sciences and the World Health Organization's Collaboration Centre for Population Health Research and Training, The University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - Devi Sridhar
- Centre for Population Health Sciences and the World Health Organization's Collaboration Centre for Population Health Research and Training, The University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - Kit Yee Chan
- Centre for Population Health Sciences and the World Health Organization's Collaboration Centre for Population Health Research and Training, The University of Edinburgh Medical School, Edinburgh, Scotland, UK
| |
Collapse
|
33
|
Comparison of three data mining models for predicting diabetes or prediabetes by risk factors. Kaohsiung J Med Sci 2013; 29:93-9. [DOI: 10.1016/j.kjms.2012.08.016] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 03/12/2012] [Indexed: 11/22/2022] Open
|
34
|
Babu RB, Alam M, Helis E, Fodor JG. Population-based versus high-risk strategies for the prevention of cardiovascular diseases in low- and middle-income countries. Indian Heart J 2012; 64:439-43. [PMID: 23102379 DOI: 10.1016/j.ihj.2012.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2012] [Revised: 08/01/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022] Open
Abstract
Cardiovascular diseases (CVD) are now the number one cause of death in low- and middle-income countries (LMIC), such as those in South East Asia (SEA). It is projected that SEA countries will have the greatest total number of deaths due to non-communicable diseases (NCDs) by 2020. In low resource countries, the rising burden of CVDs imposes severe economic consequences that range from impoverishment of families to high health system costs and the weakening of country economies. There are two possible options to be considered for addressing this issue: a "population-based strategy" and/or a "high risk" strategy. The question is, what is the optimal way to reduce the excessive burden of these diseases in the LMICs. We believe that by applying systematic policy and smoking cessation programs with proven effectiveness, there is a chance that the high smoking prevalence, particularly among SEA.
Collapse
Affiliation(s)
- Ramesh B Babu
- Medwin Hospital, Raghava Ratna Towers, Nampally, Hyderabad, Andhra Pradesh, India.
| | | | | | | |
Collapse
|
35
|
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. [PMID: 22630043 PMCID: PMC3447674 DOI: 10.1186/1471-2458-12-380] [Citation(s) in RCA: 170] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2012] [Accepted: 05/07/2012] [Indexed: 01/28/2023] Open
Abstract
Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic) and ‘Epidemology/EP’ (MeSH subheading). Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years). The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural), India–4.6%:12.5% (2007;Rural); Maldives–3.0%:3.7% (2004;National), Nepal–19.5%:9.5% (2007;Urban), Pakistan–3.0%:7.2% (2002;Rural), Sri Lanka–11.5%:10.3% (2005–2006;National). Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%), while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%). Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .
Collapse
Affiliation(s)
- Ranil Jayawardena
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
| | | | | | | | | | | |
Collapse
|
36
|
Prasad DS, Kabir Z, Dash AK, Das BC. Prevalence and risk factors for diabetes and impaired glucose tolerance in Asian Indians: a community survey from urban eastern India. Diabetes Metab Syndr 2012; 6:96-101. [PMID: 23153977 DOI: 10.1016/j.dsx.2012.05.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the prevalence of diabetes and impaired glucose tolerance (IGT) and to identify risk factors for the same specific to an underdeveloped urban locale of Eastern India. METHODS Study design. Population based cross-sectional study, with multistage random sampling technique. Setting. Urban city-dwellers in Orissa one of the poorest states of Eastern India bordering a prosperous state of Andhra Pradesh of Southern India. Participants. 1178 adults of 20-80 years age randomly selected from 37 electoral wards of urban populace. Definition and diagnosis of diabetes mellitus and IGT. These were based on a Report of a World Health Organization/International Diabetes Federation Consultation of 2006. Main outcome measure. Prevalence and significant risk factors for Diabetes and IGT. Statistical analysis. Both descriptive and multivariable logistic regression analyses. RESULTS The crude rates of diabetes and IGT in the study population were 15.7% and 8.8%, respectively. Similarly age-standardized rates of diabetes and IGT were 11.1% and 6.7%, respectively. Both diabetes and IGT had shown a male preponderance. CONCLUSION Diabetes and IGT were very highly prevalent in this urban populace. Cardiometabolic risk factors like older age, central obesity, inadequate fruit intake, hypertension, hypertriglyceridemia and socio economic status were found to be significant predictors of diabetes in this study.
Collapse
Affiliation(s)
- D S Prasad
- Sudhir Heart Centre, Berhampur, Orissa, India.
| | | | | | | |
Collapse
|
37
|
Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, Bhansali A, Joshi SR, Joshi PP, Yajnik CS, Dhandhania VK, Nath LM, Das AK, Rao PV, Madhu SV, Shukla DK, Kaur T, Priya M, Nirmal E, Parvathi SJ, Subhashini S, Subashini R, Ali MK, Mohan V. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study. Diabetologia 2011; 54:3022-7. [PMID: 21959957 DOI: 10.1007/s00125-011-2291-5] [Citation(s) in RCA: 457] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 07/28/2011] [Indexed: 02/07/2023]
Abstract
AIMS/HYPOTHESIS This study reports the results of the first phase of a national study to determine the prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in India. METHODS A total of 363 primary sampling units (188 urban, 175 rural), in three states (Tamilnadu, Maharashtra and Jharkhand) and one union territory (Chandigarh) of India were sampled using a stratified multistage sampling design to survey individuals aged ≥ 20 years. The prevalence rates of diabetes and prediabetes were assessed by measurement of fasting and 2 h post glucose load capillary blood glucose. RESULTS Of the 16,607 individuals selected for the study, 14,277 (86%) participated, of whom 13,055 gave blood samples. The weighted prevalence of diabetes (both known and newly diagnosed) was 10.4% in Tamilnadu, 8.4% in Maharashtra, 5.3% in Jharkhand, and 13.6% in Chandigarh. The prevalences of prediabetes (impaired fasting glucose and/or impaired glucose tolerance) were 8.3%, 12.8%, 8.1% and 14.6% respectively. Multiple logistic regression analysis showed that age, male sex, family history of diabetes, urban residence, abdominal obesity, generalised obesity, hypertension and income status were significantly associated with diabetes. Significant risk factors for prediabetes were age, family history of diabetes, abdominal obesity, hypertension and income status. CONCLUSIONS/INTERPRETATIONS We estimate that, in 2011, Maharashtra will have 6 million individuals with diabetes and 9.2 million with prediabetes, Tamilnadu will have 4.8 million with diabetes and 3.9 million with prediabetes, Jharkhand will have 0.96 million with diabetes and 1.5 million with prediabetes, and Chandigarh will have 0.12 million with diabetes and 0.13 million with prediabetes. Projections for the whole of India would be 62.4 million people with diabetes and 77.2 million people with prediabetes.
Collapse
Affiliation(s)
- R M Anjana
- Madras Diabetes Research Foundation and Dr Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control, IDF Centre for Education, 4, Conran Smith Road, Gopalapuram, Chennai 600 086, India
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|