Indian Diabetes Risk Score Score Research Articles

Diabetes risk assessment with Indian Diabetes Risk Score: A cross-sectional study among adults in rural Mandya, Karnataka

Background: Screening for diabetes using the Indian Diabetes Risk Score (IDRS) is an inexpensive yet effective way of early diagnosis. Aims and Objectives: The present study was conducted to assess the risk of developing diabetes among individuals in rural field practice areas using IDRS. Materials and Methods: A community-based observational study was conducted among persons aged 20 years and older in the rural field practice area for 2 months. A semi-structured interview schedule, including the “IDRS” questionnaire, was used to obtain the data. Results: Out of 1100 subjects, around 50% were above 50 years, only 38.6% of the subjects had a waist circumference within the normal limits; 73.8% did moderate exercise; 86% of the subjects had no history of diabetes in their parents. The mean IDRS score of the subjects was 44.12±14.33, ranging from 10 to 90. Nearly 2/3rd (69.6%) of them were at moderate risk, and 21.2% were at high risk for developing diabetes. The IDRS score was significantly higher among those with diabetes and hypertension. Conclusion: The majority of the subjects in our study had a moderate to high risk of developing diabetes as per the IDRS.

Comparison of triglyceride/glucose index and related parameters with Indian Diabetes Risk Score assessment in non-diabetic individuals visiting primary healthcare centre-A community-based cross-sectional study.

Diabetes mellitus is a chronic metabolic disorder and has reached epidemic proportions in developing countries like India. Our study aimed to identify relationship between triglyceride glucose (TyG) index and related parameters with Indian diabetes risk score in non-diabetic individuals. An analytical cross-sectional study was conducted in community at a primary healthcare centre attached to a medical college for six months from April 2022 to October 2022 after getting approval from institute ethical committee. We conducted a cross-sectional study at a primary healthcare centre attached to the medical college for six months duration with a sample size of 107, aged ≥18 years, which included apparently healthy individuals not diagnosed with any type of diabetes. Indian diabetes risk score (IDRS) scale was calculated along with anthropometric measurements and biochemical laboratory investigations like fasting triglyceride and fasting blood glucose. Our study population included 53.3% male and 46.7% female; the mean age of male was 29.70 ± 12.26 and female was 34.28 ± 11.91. The mean TyG index for male and female was 8.48 ± 0.45 and 8.39 ± 0.52, respectively. 52.3% of our study population belonged to high-risk category, and 47.7% belonged to moderate-risk category. We also found positive correlation between TyG index and its related parameters and IDRS score. In linear regression between IDRS and TyG index, we found positive correlation, and in logistic regression showed for every 1 unit rise in age, there was 1.28 times increase in IDRS score (P < 0.001). TyG-WHtR was superior to other TyG-related parameters in identifying high IDRS score (P < 0.001). TyG index and its related parameters can be used as a predictor in identifying diabetes mellitus along with IDRS score assessment in low-cost clinical settings like primary healthcare centre.

Diabetes Susceptibility Assessment Using the Indian Diabetes Risk Score: A Cross-Sectional Analytical Study on Young Medical Students in Chennai, South India.

Background Youth must identify their diabetes risk factors because the disease is currently affecting young people at an epidemic rate. The Indian Diabetes Risk Score (IDRS) is a reliable and affordable method for determining a person's risk of developing diabetes. This study aims to evaluate the ability of the IDRS to predict type 2 diabetes mellitus (T2DM) and investigate the relationship between diabetes risk and other variables in young medical students. Methodology In this cross-sectional analytical survey of a cohort of 670 undergraduate medical scholars over six months, a meticulously designed semi-structured questionnaire was administered. The questionnaire captured sociodemographic specifics, substance use habits (tobacco and alcohol), dietary patterns, and physical activity patterns in line with the WHO STEPwise approach to non-communicable disease risk factor surveillance and the IDRS tool. Results There was an equal proportion of males and females. The majority were in their second year of study. Overall, 5.2% of students reported tobacco use, while alcohol consumption was reported by 25.6% of the cohort. Furthermore, IDRS score insights revealed that 80.2% of the participants exhibited low diabetes risk, 18.9% were categorized as moderate risk, and 0.9% demonstrated high risk. Gender (adjusted prevalence ratio (PR) = 1.8, 95% confidence interval (CI) 1.3-2.7)and tobacco usage (adjusted PR = 1.6 (1.1 to 2.2)) were found to be significantly associated with higher IDRS scores on multivariable analysis. Conclusions Illuminating the landscape of risk determinants among medical students in Chennai, this study accentuates the pressing need for bespoke interventions, underpinned by behavioral change theories. Such strategies can potentially catalyze healthier lifestyle shifts, shaping favorable public health trajectories in the foreseeable future.

A randomized, controlled, comparative, proof-of-concept study to evaluate the efficacy and safety of Nisha-Amalaki capsules in prediabetic patients for preventing progression to diabetes

BackgroundPrediabetes is an intermediate state of hyperglycemia, which acts as a precursor to Diabetes mellitus if left untreated. Nisha (Curcuma longa) and Amalaki (Emblica officinalis) combination has been advocated as drugs of choice to treat the early manifestations of Diabetes mellitus. ObjectiveThis prospective, randomized, single-blind, placebo-controlled, comparative study was planned to assess the efficacy and safety of Nisha-Amalaki capsules in preventing progression to Diabetes mellitus in prediabetic patients when administered for 6 months. MethodsThe study was conducted on prediabetic participants randomized to receive either Nisha-Amalaki (500 mg) or placebo one capsule twice a day for six months. The effect of study medications on IDRS (Indian Diabetes Risk Score), BMI (Body Mass Index), blood sugar, serum insulin, HOMA-IR (Homeostasis Model Assessment-Estimated Insulin Resistance), HbA1c (glycated hemoglobin), oxidative markers, Ayurvedic symptoms and Quality of Life (QoL) scores was assessed at regular intervals. Results58 of the 62 participants enrolled completed the study. Significant fall in IDRS score [p < 0.001], BMI [p < 0.001], fasting, and 2 h post-OGTT sugar, insulin, HbA1c, HOMA-IR, and oxidative stress markers [p < 0.001] was observed in patients receiving Nisha-Amalaki at 6 months. Ayurvedic symptoms and QoL scores also improved at 6 months in the treatment group. ConclusionTreatment with Nisha-Amalaki capsules improved all study parameters including insulin sensitivity at 6 months as compared to placebo in prediabetic patients. Thus Nisha-Amalaki should be considered as prophylactic therapy in prediabetics to delay progression to diabetes.

Usefulness of Indian Diabetes Risk Score in Predicting Treatment-Induced Hyperglycemia in Women Undergoing Adjuvant Chemotherapy for Breast Cancer

In the curative treatment of cancer with adjuvant chemotherapy, antineoplastic drugs, along with glucocorticoids, can induce hyperglycemia. The objective of this study was to assess the utility of the Indian Diabetes Risk Score (IDRS) in predicting treatment-induced hyperglycemia in women who were nondiabetic and normoglycemic at the start of chemotherapy. This prospective study was conducted with nondiabetic women who required adjuvant chemotherapy. Participants voluntarily completed the IDRS, providing information on age, waist circumference, family history of diabetes, and physical activity. Chemotherapy-induced hyperglycemia was defined as fasting blood glucose levels ≥100 mg/dL or random blood glucose levels ≥140 mg/dL during treatment. Data were categorized into women who developed hyperglycemia and those who remained normoglycemic during treatment and were analyzed using Fisher's exact test. A significance level of p &lt; 0.05 was applied. Receiver operating characteristic (ROC) curves were constructed to validate the IDRS for predicting hyperglycemia. A total of 208 women met the inclusion criteria and participated in the study. The results revealed that 38.93% (81/208) developed hyperglycemia by the end of chemotherapy, as observed during their first follow-up after treatment. Fisher's exact test demonstrated a significant difference in the total IDRS score and its domains, including family history, physical activity, and waist circumference (p = 0.017–&lt; 0.001), but not age. ROC analysis indicated that an IDRS score above 60 increased the likelihood of developing hyperglycemia, with a sensitivity of 81.3%, specificity of 54.7%, and an area under the curve of 0.727. These findings suggest that the IDRS is a sensitive tool for predicting adjuvant chemotherapy-induced hyperglycemia in breast cancer patients without diabetes. To the best of the authors' knowledge, this is the first study to evaluate the utility of the IDRS in predicting treatment-induced hyperglycemia in women undergoing adjuvant chemotherapy for breast cancer. Ongoing efforts are focused on understanding the underlying mechanisms and strategies for mitigation.

Risk Assessment of Type II Diabetes using Indian Diabetic Risk Score in Andhra Pradesh, India: A Cross-sectional Study

Introduction: Diabetes has emerged as a global pandemic of the 21st century, with approximately 463 million adults (aged 20- 79 years) living with diabetes worldwide in 2019. Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes compared to Type 1 and other forms. The burden of diabetes in India is expected to increase in the coming years. The Indian Diabetes Risk Score (IDRS) is a validated and cost-effective tool used to identify the risk of developing diabetes among the population. Aim: To estimate the risk of T2DM using the IDRS in adults aged 25 years and above. Additionally, the study aimed to explore the association between the risk of diabetes and other factors. Materials and Methods: An observational, community-based, cross-sectional study was conducted in the field practice area of Kurnool Medical College, Kurnool, Andhra Pradesh, India. Data collection took place from December 2022 to February 2023, using a simple random sampling technique. The study included residents aged over 25. A sample size of 100 participants was selected. The IDRS, developed by the Madras Diabetic Research Foundation (MDRF), was used as a validated tool to screen individuals at high-risk of developing T2DM. Data was collected using a semistructured questionnaire that included socio-demographic information, the IDRS tool to detect the risk of developing diabetes, and other risk factors such as Body Mass Index (BMI), family history of diabetes, physical activity, smoking, alcohol consumption, and hypertension. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 23.0. The Chi-square test was used to determine significance, with a p-value of &lt;0.05 considered significant. Results: A total of 100 residents aged over 25 years were included in the study. IDRS categorisation revealed that 14 (14%) were at low risk, 43 (43%) at moderate risk, and 43 (43%) at high-risk for developing T2DM, respectively. A statistically significant association was observed between diabetes risk score and individuals who smoked (p=0.04), consumed alcohol (p=0.04), and had hypertension (p&lt;0.001). BMI showed a positive correlation with IDRS score (p=0.031), family history score (p=0.028), and waist circumference score (p=0.034). Conclusion: Early detection of the risk of diabetes through periodic screening and effective behavioural change communication could be instrumental in controlling the diabetes crisis.

Indian Diabetes Risk Score (IDRS) as a strong predictor of diabetes mellitus: A cross sectional study among urban population of Jhalawar, Rajasthan

Introduction: The patients with Type 2 diabetes Mellitus may often remain asymptomatic for a longer period of time. The Indian Diabetes Risk Score (IDRS), a simple screening tool for prediction of undiagnosed diabetes. Objective: Validation of IDRS with standard test for type 2 diabetes among urban population of Jhalawar, Rajasthan. Material and Methods: A Community based Cross-sectional study was carried out in urban field practice area of Department of Community Medicine, Jhalawar Medical College, Jhalawar, Rajasthan. The study was conducted using a two-stage sampling design. A predesigned, pretested proforma and Indian Diabetes Risk Score (IDRS) sheet was used to collect data from the study participants. The IDRS is based on four parameters: age, family history of diabetes, waist circumference and physical inactivity. Data was collected using the World Health Organization stepwise approach to surveillance (STEPS). Results: Among 450 participants, 12.7% participants were in low risk, 59.1% were in moderate risk and 28.2% were in high risk of developing diabetes according to IDRS score. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes with sensitivity 92.3% and specificity 82.6%. Positive Predictive value and Negative Predictive value were 47.3% and 98.5% respectively. Conclusion: Association of IDRS was found significant with diabetes. IDRS score of ?60 turned out to be the best cut point for identifying undiagnosed diabetes. IDRS is found valid screening tool for early detection of Diabetes.

Recalibrating the Non-Communicable Diseases risk prediction tools for the rural population of Western India

BackgroundThe aim of the present study was to recalibrate the effectiveness of Indian Diabetes Risk Score (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistic screening of Diabetes Mellitus (DM) and Hypertension (HT) among the people attending health centres, and estimating the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) among them using WHO/ISH charts.MethodsAll the people aged ≥ 30 years attending the health centers were screened for DM and HT. Weight, height, waist circumference, and hip circumferences were measured, and BMI and Waist-Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score, and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden’s index were calculated for different cut-offs of IDRS and CBAC scores.ResultsA total of 942 participants were included for the screening, out of them, 9.2% (95% CI: 7.45–11.31) were diagnosed with DM for the first time. Hypertension was detected among 25.7% (95% CI: 22.9–28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score > 4. As much as 26.1% were at moderate to higher risk (≥ 10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58–0.70), with 67.1% SN and 55.2% SP (Youden’s Index 0.22). While the AUC for CBAC was 0.59 (0.53–0.65). For hypertension both the AUCs were 0.66 (0.62–0.71) and 0.63 (0.59–0.67), respectively.ConclusionsIDRS was found to have the maximum AUC and sensitivity thereby demonstrating its usefulness as compared to other tools for screening of both diabetes and hypertension. It thus has the potential to expose the hidden NCD iceberg. Hence, we propose IDRS as a useful tool in screening of Diabetes and Hypertension in rural India.

Assessment of diabetes risk profile in a rural population of northern India using the Indian Diabetes Risk Score - A community-based study.

Diabetes is one of the leading killers among noncommunicable diseases of the present time and poses a considerable burden to the society in terms of public health. The Indian Diabetes Risk Score (IDRS) can be used as a risk assessment tool to estimate the population at risk and plan appropriate interventions. The present study was conducted to assess the diabetes risk profile of a rural population of Punjab by using IDRS. This was a cross-sectional study conducted in two phases after obtaining approval from the Institutional Ethics Committee. Phase 1 was done in Rural Health Training Center (RHTC), Pohir, where every fifth patient attending the outpatient department was included in the study. Phase 2 was conducted in village Gopalpur, which is one of the villages in the field practice area of Department of Community Medicine, where participants were enrolled by conducting house to house survey after taking their informed consent. Sociodemographic characteristics, risk factor profile, and the IDRS of the participants were noted. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0 to calculate the percentages. Pearson's Chi-square test was used for qualitative variables, and mean, standard deviation and analysis of variance (ANOVA) were used for quantitative variables. A P value of less than 0.05 was considered significant. A total of 252 subjects (99 male and 153 female) from RHTC and 213 subjects (71 male and 142 female) from village Gopalpur participated in the study, with their mean IDRS being 44.8 ± 15.7 and 46.6 ± 21.1, respectively. On calculating the IDRS of participants enrolled in RHTC, it was found that 15.5% had low, 56% had moderate, and 28.5% had high risk, whereas from village Gopalpur, 19.2% had low, 57.3% had moderate, and 23.5% had high risk for developing diabetes mellitus. The risk for developing diabetes was found to be higher among females, subjects living in joint families, and subjects with high body mass index (BMI). The mean systolic and diastolic blood pressure showed an increasing trend with increase in IDRS score of the participants. The present study showed that even in rural areas, nearly one-fourth of the adult population was at high risk, whereas more than half of the population was at moderate risk of developing diabetes mellitus. This corroborates the World Health Organization's (WHO's) stand to declare diabetes as a public health emergency and to devise ways to urgently mitigate this problem. Therefore, awareness and health education campaigns should be implemented in rural areas for early identification of risks, which will help in prevention and hence decreasing the burden of the disease.

Indian diabetes risk profile of employees in a tertiary care facility in north Maharashtra: a cross sectional study

Background: The rising prevalence of type 2 diabetes (T2D) in India calls for screening of at-risk adults. Objectives were to assess IDRS (Indian diabetes risk score) of T2D in staff in tertiary care hospital, and to assess covariates random blood sugar (RBS), BMI, skinfold thickness (SFT), pre-existing T2D in the employees.Methods: In this cross sectional study, IDRS was used to assess all staff in a tertiary care institute. Anthropometric measurements, BP and RBS were done. Information on parental T2D, cereal intake and weekly physical activity (PA) was obtained in interview.Results: 370 subjects (F-117, M-273) with mean age 30.81 (7.99), BMI 22.89 (14.13) years were screened. Subjects in moderate and sedentary work were 185 each, 15% women and 39% men had higher waist size. Total 5.4% subjects had T2D including known diabetics. RBS in women and men was 113.1 (27.87), 114.7 (27.66), with IDRS score high in 29 (7.84%) and moderate in 144 (38.92%). Parental T2D was present in 19.5% subjects. IDRS risk was strongly associated with type of work (Chi-square 79.0283, df=4, p=0.00). Multiple logistic regression for IDRS risk outcome showed association of age (OR 1.4), BMI (OR1.3), parental T2D (OR 9.6) with highly significant p values. Multiple linear regression for RBS outcome was associated with age (OR 1.3) and BMI (OR 1.4) but the results were statistically not significant.Conclusions: Pooled IDRS risk was present in 47% subjects despite younger age of study population. Improvements in physical activity and reduction in waist size is the need of the hour.

158Prediction of diabetes and hypertension by opportunistic screening: A facility based study from rural Jodhpur

Abstract Background Nearly half of population with Diabetes and Hypertension is estimated to be undetected in India. The objectives of this study were to conduct opportunistic screening for Diabetes and Hypertension coming to OPD of health centres under Department of Community Medicine and Family Medicine, AIIMS Jodhpur, India and to develop the models for prediction of Diabetes and Hypertension. Methods Time bound study was conducted at three rural health centres between 2018-19. A total of 942 patients aged ≥30 years were screened. Data was recorded using Epicollect5. Risk assessment was done by using Indian Diabetes risk score (IDRS), Community based assessment checklist (CBAC), Waist Hip Ratio, &amp; BMI. Random and fasting capillary blood sugar and BP was measured. Results The mean age of the participants was 52.4 ± 13.5 years. As much as 446 (47.4%) had IDRS score of ≥ 60 and 276 (29.3%) had CBAC score of ≥ 4. RBS level of ≥ 140mg/dl was found among 223 participants, of these, 42.5% were diagnosed to be diabetic on FBS. One-fourth (25.6%) were estimated to be hypertensive. Physical activity and hypertension were best predicting the diabetes (r2= 90.8), while hypertension was best predicted by age and BMI (r2= 74.3). Conclusions Prevalence of diabetes and hypertension was in accordance with the reported prevalence in the country. As compared to existing models, less number of prediction variables were identified for NCDs. Key messages The study highlights the need for implementation of hospital based opportunistic screening and point out the necessity to revise the existing prediction models for NCDs.

Awareness Regarding Diabetes Mellitus among General Population of Banepa Municipality

Background Diabetes is a silent disease and many people with diabetes may become aware of it only after life-threatening complications. The presence of knowledge of diabetes could contribute in early diagnosis and minimize the occurrence of complications. Hence, healthcare and public policy makers are putting extensive efforts to aware them on diabetes.&#x0D; Objective To assess the level of diabetes knowledge and its risk among the general public of Banepa municipality.&#x0D; Method A Cross sectional study was conducted to assess the awareness about diabetes among the general public of Banepa municipality. During the period of November 2019 to January 2020, 273 respondents of Banepa municipality were included with informed consent. Data was collected using a pre-tested structured questionnaire through one-to-one interviews. Indian Diabetes risk score (IDRS) was used to identify the risk of diabetes among them that consists of four elements i.e. age, abdominal obesity, physical activity, and family history. Data entry and analysis was done using SPSS version 20.&#x0D; Result It was found that 61.9% had a higher level of knowledge of diabetes. IDRS score shows more than half percent (53.5%) of respondents were in high risk, 39.2% were in medium risk and 7.3% were in low risk.&#x0D; Conclusion This study implies that there was good knowledge about diabetes among people. However, the majority of them are at risk for developing diabetes in future which may be due to lack of practical implication of knowledge. It reflects the necessity to educate and reinforce the public regarding prevention of diabetes which further postpones its complications.

Prevalence of Diabetes and Its Determinants in the Young Adults Indian Population-Call for Yoga Intervention.

BackgroundThe young Indian population, which constitutes 65% of the country, is fast adapting to a new lifestyle, which was not known earlier. They are at a high risk of the increasing burden of diabetes and associated complications. The new evolving lifestyle is not only affecting people’s health but also mounting the monetary burden on a developing country such as India.AimWe aimed to collect information regarding the prevalence of risk of diabetes in young adults (<35 years) in the 29 most populous states and union territories (7 zones) of India, using a validated questionnaire.MethodsA user-friendly questionnaire-based survey using a mobile application was conducted on all adults in the 29 most populous states/union territories of India, after obtaining ethical clearance for the study. Here, we report the estimation of the prevalence of the risk of diabetes and self-reported diabetes on 58,821 young individuals below the age of 35 years. Risk for diabetes was assessed using a standardized instrument, the Indian diabetes risk score (IDRS), that has 4 factors (age, family history of diabetes, waist circumference, and physical activity). Spearman’s correlation coefficient was used to check the correlations.ResultsThe prevalence of high (IDRS score > 60), moderate (IDRS score 30–50), and low (IDRS < 30) diabetes risk in young adults (<35 years) was 10.2%, 33.1%, and 56.7%, respectively. Those with high-risk scores were highest (14.4%) in the Jammu zone and lowest (4.1%) in the central zone. The prevalence of self-reported diabetes was 1.8% with a small difference between men (1.7%) and women (1.9%), and the highest (8.4%) in those with a parental history of diabetes. The south zone had the highest (2.5%), and the north west zone had the lowest (4.4%) prevalence.ConclusionsIndian youth are at high risk for diabetes, which calls for an urgent action plan through intensive efforts to promote lifestyle behavior modifications during the pandemics of both communicable and noncommunicable diseases.

Management of Type II Diabetes by Modulating the Modifiable Risk Factors: A Future Roadmap for Prevention of Cerebrovascular Complications.

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.

Assessment of risk of Diabetes Mellitus among National highway truck drivers in Tamil Nadu

Background:&nbsp;Diabetes mellitus, type II, is a major public health concern worldwide. The recent World Health Organization report suggests that over 19% of the world’s diabetic population currently resides in India. Indian Diabetes Risk Score (IDRS) developed by Dr.Mohan and his colleagues (Mohan, 2005) is a simplified risk score for identifying undiagnosed diabetic subjects using four simple parameters (age, waist circumference, family history of diabetes and physical activity) in which the minimum score is 0 and maximum is 100 &amp; score 60 and above is indicative of diabetes risk. Objectives:&nbsp;To assess the risk of Diabetes mellitus among national highway truck drivers using an IDRS score. Materials and Methods: A cross sectional study was conducted during December 2018 to January 2019 among truck drivers aged 18 years and above in the Lay-By, Padalam, Maduranthagam, Kancheepurm District, Tamil Nadu. The particpants were interviewed using a structured questionnaire consisting of socio-demographic details and Anthropometric measurement and Indian Diabetic Risk Score (IDRS). Result: Among 117 study participants, 71 (60.6) were 35 to 49 years 81 (69.3%) were literate and 106 (90.6%) were full time drivers. On evaluating the risk status of study subjects using IDRS, 42.7% had moderate risk, 35.8% had high risk score and 21.3% had low risk. With increase in age and waist circumference and not doing physical activity was increase in the risk status for diabetes. Conclusion:&nbsp;Majority of the subjects in our study belonged to the moderate risk and high risk category. A statistically significant association was seen between the age, occupation, type of family, Waist circumference and Physical activity. (p&lt;0.005) &nbsp

Risk of type 2 diabetes mellitus among urban slum population using Indian Diabetes Risk Score.

Background and objectives:Diabetes has emerged as a major health challenge in India due to a rapid rise in the number of diabetes cases. Early identification of high risk individuals through screening and early interventions in the form of lifestyle modifications and treatment would help in the prevention of diabetes and its complications. This study was done to assess the risk of type 2 diabetes mellitus (T2DM) in an urban slum population using the Indian Diabetes Risk Score (IDRS) and to determine the factors associated with high risk score.Methods:A community-based cross-sectional study was conducted among the urban slum population in North Telangana, India. A total of 136 study participants were selected randomly from the records. A pre-designed and pre-tested structured questionnaire was used for data collection. Assessment of risk of T2DM was done using the IDRS.Results:Of the 136 study participants, 101 (74.3%) were at high risk (IDRS ≥60) followed by 32 (23.5%) at moderate risk (IDRS 30-50) and three (2.2%) at low risk (IDRS <30). Sixty two (92.5%) individuals in the age group ≥50 yr were at high risk compared to 34 (63%) in 35-49 yr age group. Most (n=35, 87.5%) of sedentary workers were at high risk compared to those employed in moderate (n=52, 75.4%) and strenuous work (n=14, 51.9%).Interpretation & conclusions:Nearly three-fourth (74.3%) of the study participants were at a high risk of developing T2DM. Age, type of occupation, abdominal obesity, general obesity and high blood pressure were the factors significantly associated with high risk IDRS score.

Participant recruitment into a community-based diabetes prevention trial in India: Learnings from the Kerala Diabetes Prevention Program.

BackgroundData on participant recruitment into diabetes prevention trials are limited in low- and middle-income countries (LMICs). We aimed to provide a detailed analysis of participant recruitment into a community-based diabetes prevention trial in India.MethodsThe Kerala Diabetes Prevention Program was conducted in 60 polling areas (electoral divisions) of the Neyyatinkara taluk (subdistrict) in Trivandrum district, Kerala state. Individuals (age 30–60 years) were screened with the Indian Diabetes Risk Score (IDRS) at their homes followed by an oral glucose tolerance test (OGTT) at community-based clinics. Individuals at high-risk of developing diabetes (IDRS score ≥60 and without diabetes on the OGTT) were recruited.ResultsA total of 1007 participants (47.2% women) were recruited over nine months. Pilot testing, personal contact and telephone reminders from community volunteers, and gender matching of staff were effective recruitment strategies. The major recruitment challenges were: (1) during home visits, one-third of potential participants could not be contacted, as they were away for work; and (2) men participated less frequently in the OGTT screening than women (75.2% vs. 84.2%). For non-participation, lack of time (42.0%) was most commonly cited followed by ‘I am already feeling healthy’ (30.0%), personal reasons (24.0%) and ‘no benefit to me or my family’ (4.0%). An average of 17 h were spent to recruit one participant with a cost of US$23. The initial stage of screening and recruitment demanded higher time and costs.ConclusionsThis study provides valuable information for future researchers planning to implement community-based diabetes prevention trials in India or other LMICs.Trial registrationAustralia and New Zealand Clinical Trials Registry: ACTRN12611000262909.

PDB66 ASSESSMENT OF RISK OF TYPE 2 DIABETES IN HEALTHY VOLUNTEERS USING SIMPLIFIED INDIAN DIABETES RISK SCORE TOOL: A CROSS-SECTIONAL STUDY IN NORTH INDIA

The large contribution of the world’s diabetic population resides in India making India as diabetic capital of the world. There is large burden of undetected diabetic cases in community, which prompts to assess the early diabetes risk in vulnerable population. Madras Diabetes Research Foundation (MDRF) has developed Indian Diabetes Risk Score (IDRS) to detect undiagnosed Type 2 diabetes. This study was aimed to assess the risk of diabetes in North Indian population. This community-based cross-sectional study enrolled adult population aged between 20 to 55 years. Simple random sampling was performed to select the participants. The assessment of risk of diabetes was carried out in and around Chandigarh by employing IDRS tool which consist of two modifiable (waist circumference, physical activity) and two non-modifiable risk factors (age, family history) for diabetes. Pearson’s Chi-square was used as a test of significance. P-value < 0.05 was considered statistically significant. A total of 478 (males=78.24%) participants were enrolled. Mean and SD for age of the study subjects were 27.08 ± 7.77 years, BMI 22.97 ± 8.25 kg/m2, waist circumference [(males 82.77±6.84 cm), (females 0.95 ± 0.06 cm)]. A total of 343 (71.8%) had IDRS score below 30, ninety four (19.7%) having 30-59 and forty-one (8.58%) with a score greater than 60. Participants having history of smoking, illiteracy, less physical exercise and House workers were found to be on high risk of Type 2 diabetes. A very less proportion of the participants were at high risk for diabetes. IDRS is a simple and easy to use and cost effective tool to assess the risk of type 2 diabetes in the community.

Opportunistic screening for diabetes using Indian diabetes risk score among patients aged 30 years and above attending rural health training center in Delhi

Background: Diabetes prevalence has been rising more rapidly in middle- and low-income countries which is attributed to a combination of factors - unhealthy diets, rapid urbanization, tobacco use, sedentary lifestyles and increasing life expectancy. Objectives: The objective of the study was to estimate the proportion of patients at risk of developing diabetes mellitus using IDRS and to identify various factors associated with the risk of developing diabetes mellitus. Material and Methods: A facility based cross-sectional study was conducted in the rural health training center among 185 patients aged ≥30 years. Data was collected using a questionnaire containing sociodemographic details and Indian Diabetes Risk Score (IDRS) scale. Random Blood Glucose (RBS) of all the patients was also estimated. Data was analysed using MS Excel and SPSS 20.0 by doing frequencies, chi square test and multiple logistic regression. Results: The mean age of the participants was 46.6 (±12.31) years with majority of females (133;71.9%), Hindu (174; 94%), illiterate (122;65.9%) and patients from upper lower socio-economic status (127;68.6%). Fifty-four (29.2%) participants had RBS levels of ≥140mg/dl. The prevalence of high risk, moderate risk and low risk of diabetes among participants was 49.2%, 46.5% and 4.3% respectively. The significant determinants found on univariate analysis were gender, occupation, blood pressure, BMI and RBS. However, after applying multiple logistic regression it was found out that blood pressure (95% CI=1.122-4.990, P =0.024) and BMI (95% CI= 1.471-6.711, P =0.003) were the main predictors of IDRS score. Conclusion: This study highlights the importance of screening programs for early identification of high risk people where simple lifestyle interventions can help prevent or delay the onset of the disease.

A peer-support lifestyle intervention for preventing type 2 diabetes in India: A cluster-randomized controlled trial of the Kerala Diabetes Prevention Program.

BackgroundThe major efficacy trials on diabetes prevention have used resource-intensive approaches to identify high-risk individuals and deliver lifestyle interventions. Such strategies are not feasible for wider implementation in low- and middle-income countries (LMICs). We aimed to evaluate the effectiveness of a peer-support lifestyle intervention in preventing type 2 diabetes among high-risk individuals identified on the basis of a simple diabetes risk score.Methods and findingsThe Kerala Diabetes Prevention Program was a cluster-randomized controlled trial conducted in 60 polling areas (clusters) of Neyyattinkara taluk (subdistrict) in Trivandrum district, Kerala state, India. Participants (age 30–60 years) were those with an Indian Diabetes Risk Score (IDRS) ≥60 and were free of diabetes on an oral glucose tolerance test (OGTT). A total of 1,007 participants (47.2% female) were enrolled (507 in the control group and 500 in the intervention group). Participants from intervention clusters participated in a 12-month community-based peer-support program comprising 15 group sessions (12 of which were led by trained lay peer leaders) and a range of community activities to support lifestyle change. Participants from control clusters received an education booklet with lifestyle change advice. The primary outcome was the incidence of diabetes at 24 months, diagnosed by an annual OGTT. Secondary outcomes were behavioral, clinical, and biochemical characteristics and health-related quality of life (HRQoL). A total of 964 (95.7%) participants were followed up at 24 months. Baseline characteristics of clusters and participants were similar between the study groups. After a median follow-up of 24 months, diabetes developed in 17.1% (79/463) of control participants and 14.9% (68/456) of intervention participants (relative risk [RR] 0.88, 95% CI 0.66–1.16, p = 0.36). At 24 months, compared with the control group, intervention participants had a greater reduction in IDRS score (mean difference: −1.50 points, p = 0.022) and alcohol use (RR 0.77, p = 0.018) and a greater increase in fruit and vegetable intake (≥5 servings/day) (RR 1.83, p = 0.008) and physical functioning score of the HRQoL scale (mean difference: 3.9 score, p = 0.016). The cost of delivering the peer-support intervention was US$22.5 per participant. There were no adverse events related to the intervention. We did not adjust for multiple comparisons, which may have increased the overall type I error rate.ConclusionsA low-cost community-based peer-support lifestyle intervention resulted in a nonsignificant reduction in diabetes incidence in this high-risk population at 24 months. However, there were significant improvements in some cardiovascular risk factors and physical functioning score of the HRQoL scale.Trial registrationAustralia and New Zealand Clinical Trials Registry ACTRN12611000262909.