Prevalence of Risk Factors for Type Ii Diabetes Mellitus among Adults- A Community Based Cross Sectional Study

Abstract

BACKGROUND AND OBJECTIVES The burden of diabetes mellitus is expected to increase by 58%, from 51 million people in 2010 to 87 million in 2030. In rural India the prevalence rate has increased from 1% to 4-10% over last 20 years. Indian Diabetic Risk Score is a cost-effective & simple method for identifying people with higher risk of development of Diabetes Mellitus. If the disease has not yet developed, then some interventions could be undertaken to reduce the modifiable risk factors. METHODOLOGY A community based cross sectional study, conducted from January to December 2013 among rural adults aged between 30 to 60 years residing in Agasga village of Primary Health Center (PHC), Handignur which is a rural field practice area of Department of Community Medicine, Jawaharlal Nehru Medical College, Belgaum.. Total 855 participants were included in the study. After obtaining the ethical clearance, pilot study was conducted. Written informed consent was obtained from every participant before collecting the data. Data was collected on the following aspects. 1. Socio Demographic Factors. 2. Risk Factors for Diabetes Mellitus [Abdominal Obesity, Physical Activity and Family History-Based on Indian Diabetic Risk Score.] and other risk factors like Alcohol consumption, , tobacco use, Diet (Fruits and Vegetables)and raised Blood Pressure were also included. 3. Estimation of Fasting blood sugar was done, using a standardized digital glucometer (Accu Check, Roche diagnostic, Germany), using capillary finger prick method. After collecting data on socio demographic variables and risk factors participants were given a date for estimation of fasting blood sugar. They were informed not to consume anything after 9 pm on the previous day of examination. Risk prediction: Based on the Indian Diabetes Risk Score [IDRS]14, risk prediction for Diabetes Mellitus was done. After the collection of data Health Education was given to those with more than two modifiable risk factors or those who have the chances of Diabetes Mellitus in next 10 years. Statistical analysis was done using Pearson’s Chi- Square test to find out the association between demographic variables and IDRS. A probability value (P value) of less than 0.05 was considered as significant. Multiple logistic regressions were used to know the risk factors associated with Diabetes Mellitus. RESULTS 855 respondents comprising 51.54 % females and 48.53 % males were studied. 49.70 % were between age 35 – 49.71.8 % were agriculturist by occupation.77.1 % studied up to secondary school.69.3 % belonged to lower socio economic class. Most of the respondents 90.3 % indulged in moderate physical activity. 84.2 % had no family history of diabetes mellitus. 38.9 % individuals were in the overweight category and 10.3 % were obese according to Asian classification of BMI. 36.3 % % had high diabetic risk score. It is observed that chances of high diabetic score increase with the increase in BMI. Prevalence of diabetes in studied population was 9.47 %; out of these, 3.3 % known cases of diabetes mellitus had high (>60) IDRS. Co-relation between BMI and IDRS shows that, if BMI increases from <18.50 to >25, chances of high risk for developing diabetes mellitus also significantly increase. CONCLUSION AND INTERPRETATION Our study showed even in rural area 1/3rd population is at higher risk of developing Diabetes Mellitus. Higher the risk score higher was the fasting blood sugar. Study estimates the usefulness of simplified Indian diabetes risk score for identifying undiagnosed high risk diabetic subjects in India. Use of the IDRS can make mass screening for undiagnosed diabetes in India more cost effective. Implications: Early identification of risks will help in prevention and burden of disease.