Abstract
BackgroundA non-communicable disease risk factor survey (based on World Health Organization STEP approach to Surveillance, i.e., WHO-STEPS) was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. The study subjects were administered the WHO STEPS questionnaire and also underwent anthropometric and biochemical measurements. This study aimed at exploring the risk factors of diabetes using a Structural Equation Modeling (SEM) approach in the North Indian state of Punjab.ResultsOverall prevalence of diabetes mellitus among the study participants was found out to be 8.3% (95% CI 7.3–9.4%). The final SEM had excellent fit considering the model parameters. The following risk factors deemed to have a direct statistically significant effect on blood sugar status: family history of diabetes (4.5), urban residence (3.1), triglycerides (0.46), increasing waist circumference (0.18), systolic blood pressure (0.11), and increasing age (0.05). There are specific indirect effects of alcohol use (1.43, p = 0.001), family h/o diabetes (0.844, p = 0.001), age (0.156, p < 0.001), waist circumference (0.028, p = < 0.001) and weekly fruit intake (− 0.009, p = 0.034) on fasting blood glucose. Indirect effects of waist circumference, alcohol intake and age on blood sugar levels are mediated by raised blood pressure. Waist circumference mediates the indirect effects of age, family h/o of diabetes, alcohol intake and weekly fruit intake on blood sugar levels. Triglycerides also mediated the indirect effects between age and diabetes.ConclusionsFamily history of diabetes, urban residence, alcohol use, increasing age, and waist circumference are the key variables affecting diabetes status in the Indian population. The results of this study further strengthens the evidence that lifestyle changes in the form of physical activity and healthy diet are required to prevent and control diabetes. Those with family h/o diabetes constitute a high risk group and should be targeted with regular screening and lifestyle intervention package.
Highlights
A non-communicable disease risk factor survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals
Study design This study analyses data from a large household survey conducted in the state of Punjab, India using WHO-STEPwise approach to surveillance (STEPS) approach [8]
Study sampling strategy A state-wide non-communicable disease (NCD) risk factor survey based on WHO-STEPS approach was undertaken in Punjab in 2014–2015
Summary
A non-communicable disease risk factor survey (based on World Health Organization STEP approach to Surveillance, i.e., WHO-STEPS) was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. This study aimed at exploring the risk factors of diabetes using a Structural Equation Modeling (SEM) approach in the North Indian state of Punjab. Diabetes is growing at an alarming pace in India due to the rise in various risk factors in both urban and rural areas [2]. The burden of diabetes mellitus continues to increase and is primarily driven by nutrition, lifestyle and demographic transitions, unhealthy dietary habits, and physical inactivity, in the context of a stronger genetic predisposition to diabetes [3]. Against this background, a better understanding of the changing epidemiology of diabetes in India is required
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
