Prevalence and Correlates of Diabetes: Inception Cohort of a Semi-Urban Population of Southern India

IntroductionIndia has the second highest number of people with diabetes, however few studies assessed true burden and ensured screening of pre-diabetics. This cross sectional survey (inception cohort) was conducted to estimate the burden and correlates of one of the common risk factors (hyperglycemia / diabetes) likely to impact the morbidity and mortality due to Non-communicable diseases. Research Design and MethodsA cross sectional survey was conducted in villages under Chittoor District, Andhra Pradesh, India. 15,888 individuals (62.1% females and 37.9% males) above 15 years of age participated in the study. Results960 (6.04%) had a history of diabetes while 592 (3.67%) had high random capillary blood glucose (RCBG) [≥]200 mg/dL. HbA1c and fasting blood sugar was tested in a subset of those with high RCBG (n = 248) but with no self-reported diabetes and 212 (85.48%) had HbA1c levels > 6.5 and fasting blood sugar [≥]126 mg/dL. Thus, 85.48% (n = 506) with high RCBG were likely to be diabetic. The likely magnitude of diabetes in the community was 9.23%. Another 2,331 (14.67%) were found to be at a higher risk of developing diabetes (RCBG 140 to 200 mg/dL). Receiver Operator Characteristic analysis revealed waist circumference as the most important anthropometric measurement predicting high RCBG. Comparison of diabetes and non-diabetics by multivariate logistic regression showed that male gender, age, weight, history of hypertension, family history of diabetes and waist circumference played a significant role in the prevalence of diabetes. ConclusionsThere is high prevalence of diabetes in the rural and semi-urban India. Waist Circumference was the best predictor of Diabetes. RCBG can be considered as a easy, cheap, reliable and important tool for community diagnosis and management of diabetes. Strengths and limitations of the studyO_LIA large planned cross-sectional survey to establish a cohort with community participation C_LIO_LIQuality assurance and control measures at all levels for high internl validity C_LIO_LIFollow up assurance for the entire community C_LIO_LIThese results are from Cross Sectional survey data and thus provides only associations C_LIO_LIGenerealizeability to similar populations C_LI What is already known?O_LIGlobal burden of disease projected India to have a manifold increase in diabetes between 1995-2025. C_LIO_LIDiabetes threat is being under-prioritised with increasing pool of undiagnosed diabetes. C_LI What are the new findings?O_LITotal prevalence of Diabetes 9.77% and 14.67% were at risk of developing Diabetes C_LIO_LI85.5 % individuals with RCBG[≥]200mg/dL conform to diabetes as per ADA criteria. C_LIO_LIWaist Circumference was the best predictor of Diabetes. C_LI What do the new findings imply?O_LIRCBG can be a reliable, cheap and important tool for community diagnosis and management of diabetes. C_LIO_LICohort established, interventions being implememted with follow up. C_LI