Opportunistic screening for diabetes mellitus among adults attending a primary health center in Puducherry

Abstract

Background: More than half of cases with diabetes mellitus in India remain undiagnosed. Considering factors on yield and availability of resources, population-based screening is not recommended in low- and middle-income countries. Evidences on feasibility of opportunistic screening for diabetes mellitus and follow-up in rural settings are scarce. Objective: To estimate the proportion of undiagnosed diabetes mellitus among individuals aged 30 years or more attending a primary health center, and to identify factors influencing yield of such an opportunistic screening. Materials and Methods: Individuals aged 30 years and above attending a rural health center were screened for diabetes mellitus (using random blood sugar test) and for noncommunicable diseases risk factors. People who had random blood sugar level 140 mg% or more were advised to come for the follow-up visit to confirm the diagnosis. Study participants with fasting blood sugar level of ≥126 mg/dL (7.0 mmol/L) and/or 2-h postprandial blood sugar level of ≥200 mg/dL (11.1 mmol/L) were diagnosed as having diabetes mellitus. Result: Of 400 eligible participants, 81 (21.3%) had a random blood sugar level of 140 mg% or more. A total of 18 participants (4.5%) were newly diagnosed with diabetes mellitus. Overall, the number needed to screen a case of diabetes mellitus was 22. The number needed to screen was least among males (12) and highest among females (43). Conclusion: In primary care settings where more than half of the cases were unidentified in the community, opportunistic screening can be a feasible strategy to find out missed cases.