Prevalence Of Diabetes In India Research Articles

Psychosocial Well-being among Diabetic Individuals

Background: Quality of life (QoL) assessment is considered an important outcome measure in chronic disease management. With an increase in the prevalence of diabetes in India, it becomes imperative to assess QoL in diabetic patients for their better care and control. The present study aimed to assess the QoL among diabetic patients attending the diabetic outpatient clinic and probe its association with glycemic status and management. Methodology: A cross-sectional study was conducted for 4 months among 185 type 2 diabetes mellitus (T2DM) patients. Information on sociodemographic profile, diabetic history, and current medications was obtained. QoL was assessed using the General Health Questionnaire-28 (GHQ-28). The results were statistically analyzed. Results: Using GHQ-28, the psychosocial components of the patients in the fields related to somatic symptoms, anxiety and insomnia, social dysfunction, and severe depression were assessed. Significantly higher GHQ scores (P < 0.05) were noted in T2DM patients with higher glycated hemoglobin and increased plasma glucose levels, suggesting stronger associations of poorer QoL with compromised glycemic status. Insulin users exhibited higher GHQ scores (higher scores for depression subdomains) compared to noninsulin users. QoL was also found significantly dependent on the duration of diabetes and other comorbidities. Conclusion: The psychosocial well-being of the patients is significantly impacted in cases of chronic ailments like diabetes which adds to the total disease burden eventually. The present study warrants periodic assessment of QoL in diabetic individuals as a part of routine care along with advise of psychiatric counseling for those in need.

Diabetes and current Indian scenario: A narrative review

Abstract Health needs assessment plays a critical role in identifying priorities and allocating resources to enhance health outcomes and reduce disparities. This write-up focuses on the health priority of diabetic care in India and highlights the challenges faced in its management. The prevalence of diabetes in India is alarmingly high and is projected to increase in the future, making it a significant concern. Key challenges include lack of awareness among the population, poor diagnosis, limited access to quality care, medication adherence issues, and physicians’ limited time and knowledge. Insufficient awareness hampers prevention efforts and understanding of associated complications. Diagnosis and access to quality care remain major challenges, particularly in rural areas, due to various factors such as treatment costs and underdeveloped healthcare infrastructure. Medication adherence is a significant issue influenced by high costs, complex treatment regimens, and limited transportation options. Healthcare professionals face knowledge gaps and time constraints, affecting the optimal management of diabetes. The scarcity of trained professionals exacerbates the situation. The write-up also discusses current policies and programs in India for diabetes care, including the CARRS diabetes care delivery model, the Diabetes Tele Management System, and doctor training programs. While these initiatives aim to improve care, their effectiveness is not extensively evaluated. The conclusion emphasizes the need for increased awareness, improved diagnosis and access to care, medication affordability, enhanced healthcare professional training, and effective policy implementation to address the challenges in diabetic care in India.

Effective Ayurvedic management of Madhumeha (Diabetes Mellitus): A Case Study

Madhumeha known as silent killer needs to be treated as early as possible to stop onset of complication. Madhumeha is a Tridoshap redominant Vyadhi but Avrutta Vata and Bahudrava Shlesma is the main ailments. It is a subtype of Vataja Prameha. Diabetes Mellitus is a chronic metabolic disease of multifaceted etiology prevalent all over the world. However, in the recent years the prevalence of Diabetes is on rise, more upsetting in developed countries. It is a leading cause of morbidity and mortality all over the world. The global prevalence of Diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. In India cases of Diabetes Mellitus has shown surprisingly higher susceptibility which is a matter of great concern. The prevalence of Diabetes in India is currently reported to be around 13-15% and by the year 2025 it is estimated that approximately 55 million Indians will be diabetic. Methodology: A Case of 23 years female, complaining of increased frequency of Micturition, increased thirst since 7-8 months associated with loss of weight around 12-15 kg within one year, and generalized weakness was reported to Sri Kalabyraveshwara Ayurvedic Medical College & Research. Patient was under regular insulin since 1 and ½ years. Along with regular insulin, advised Shamanaaushadi, Udvartana, Virechanakarma and Nidanaparimarjana. Discussion: This Article is a discussion about a case of Diabetic mellitus successfully treated with Ayurvedic approach. Conclusion: The above described sets of Pacnchakarma treatment along with Shamanoushadhi has shown significant result clinically with speedy recovery within a month in present case study.

Lifestyle and socio-economic disparities in the prevalence of diabetes among the elderly population (aged 60+) in India: a decomposition analysis using longitudinal aging study in India data

Background: This study aimed to determine the prevalence of self-reported diabetes by sex and investigate the socio-economic, demographic, and lifestyle risk factors associated with diabetes. Additionally, it aimed to understand the coexistence of diabetes with other morbid conditions. Methods: The study design used in this research is a cross-sectional study design. This study utilized data from the longitudinal aging study in India (LASI), a nationally representative survey of older adults. The sample included 15,098 males and 16,366 females aged 60 years and above. Results: The prevalence of diabetes in India varies by state, zone, and rural/urban areas. Kerala has the highest prevalence among both men (33%) and women (28.5%). Urban areas have a higher prevalence (20%) compared to rural areas (8.5%). Hypertension and cancer are strongly associated with diabetes. Other morbid conditions like heart disease, high cholesterol, and vision problems also show significant links with diabetes. Conclusions: Diabetes in India is a significant health concern, with variations across regions and associations with comorbidities like hypertension, cancer, heart disease, high cholesterol, and vision problems. To address this, comprehensive preventive measures and health promotion campaigns are needed, targeting high-risk groups and improving healthcare access. Early detection, effective management, and promoting healthy lifestyles are crucial for diabetes prevention and control in India.

Clinical study of add on effect of Triphaladaruadi Kwatha (Vangsenokta) along with antidiabetic drug in management of Prameha (Non-Insulin Dependent Diabetes mellitus- NIDDM)

Prameha (Diabetes mellitus) is an age long disease known from vedic period and now it is a leading lifestyle disorder. Diabetes mellitus is a group of metabolic syndromes of fat, protein and carbohydrate which is due to absolute or relative deficiency of insulin. The prevalence of diabetes in India has risen from 7.1% in 2009 to 8.9% in 2019.1 The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over 134 million by 2045.2 In India, it is also 3rd leading cause of death (After heart disease and cancer). The number is projected to be twice by 2030. Type 2 diabetes makes up about 85-90% of all cases. Increase in the overall diabetes prevalence rates largely reflect an increase in risk factors for type 2, notably greater longevity and being overweight or obese. Hence preventive measures are essential and an ideal therapy is still obscure. It remains one of the baffling enigmas for clinical research. This is a randomized single blind standard controlled clinical trial conducted on 66 patients of Prameha (Type II DM & who are on antidiabetic treatment) to rule out Add on effect of Triphaladaruadi kwath of either gender between age group of 40-60 years and grouped into Group A & Group B. 33 patients in group A were on Antidiabetic drug (Metformin 500mg OD/BD and 33 patients in Group B are on same antidiabetic drug (Metformin 500mg OD/BD) with additional Triphaladaruadi kwath (Decoction) for 3 months. Results obtained in subjective and objective parameters were analyzed for the statistical significance by adapting paired ‘t’ test in the groups, Two-way ANOVA test between the groups, and Wilcoxon rank sum test. The study revealed that Group B was found to be more effective in bringing symptomatic relief and improving biochemical markers in the patients of Prameha.

Treatment Adherence in Diabetic Individuals in Rural India and Variables Influencing it: A Review of Studies Conducted in India and Recommendations for Future Research

Diabetes is one of the leading causes of morbidity and mortality in the world and India accommodates one in seven adults living with diabetes. Poor adherence to prescribed therapy is a growing concern among diabetics where they skip, adjust, or miss medication doses or refuse treatment entirely, subverting the benefits of medical care.The objectives were to review the prevalence of diabetes in India and LMICs, treatment adherence among diabetics in India and factors that contribute to non-adherence to treatment for diabetes in adults. The narrative review includes 56 articles published through PubMed, ResearchGate and Google Scholar during the period 2011-2022, and has been analysed to meet the research objectives. An increasing and alarming trend of diabetes prevalence is seen in India with diabetes control among patients far from ideal. The studies indicate low to moderate treatment adherence among diabetics in India. Treatment adherence was reported to be lower in rural areas as compared to urban areas and lesser in illiterates as compared to literates. The factors influencing adherence to prescribed diabetes management regimen can be attributed to various socio-demographic variables, health system factors, nature of the condition and treatment, associated distress and quality of life. Early detection and treatment with a continuum of care is critical in reducing the burden of diabetes. The need of the hour is a strengthened and resilient capacity at state, district, and subdistrict levels, with an emphasis on promotive and preventive care and its two-way continuity with curative care.

Prevalence of acanthosis Nigerians in patients with HIV infection and its relation with Metabolic Syndrome

According to International Diabetes Federation (IDF) prevalence of diabetes in India is 8.8%. Acanthosis Nigerians is one of the marker of insulin resistance which is easy to detect. There are not many studies which have correlated this ubiquitous clinical marker with metabolic syndrome and moreover there is no study on HIV positive patients: To study the prevalence of acanthosis Nigerians in patients with HIV-infection, attending ART clinic or admitted at a tertiary care centre and to study its relationship with metabolic syndrome.This is a cross sectional observational study done for 18 months including 300 patients. All patients with HIV-infection attending ART clinic or admitted were included in the study. Acanthosis Nigerians was found more in males as compared to females (15.35 vs 9.52%) though the difference was not statistically significant while metabolic syndrome was found in 12.7% of the patients. Comparative analysis of anthropometric data of metabolic syndrome patients with and without acanthosis Nigerians revealed larger waist circumference in patients with acanthosis Nigerians (85.44 vs 81.75) and it was statistically significant (p value 0.037). Sensitivity and specificity analysis of acanthosis Nigerians and metabolic syndrome revealed low sensitivity of acanthosis Nigerians in predicting presence of metabolic syndrome (17 %) and low positive predictive value (18.42 %). However it revealed high specificity (87.98 %) and a negative predictive value (86.97 %). Odds ratio of metabolic syndrome in presence of acanthosis Nigerians was 1.5. The CD4 count values were not significantly different in those with or without acanthosis Nigerians. The age, sex, duration of the therapy or the ART regimen did not statistically influenced occurance of acanthosis NigeriansAcanthosis Nigerians is a common and easily accessible dermatological condition. Increased waist circumference and waist hip ratio are strong predictors of acanthosis Nigerians. Acanthosis Nigerians can be used to predict occurrence of metabolic syndrome with high specificity and patients should be thoroughly evaluated for metabolic syndrome in its presence.

Prevalence of Self-care Practices among Type 2 Diabetes Mellitus Patients and its Effect on Glycemic Control: A Cross-sectional Study in Secondary and Tertiary Health-care Centers in Lucknow.

Globally, prevalence of diabetes is 10.5%, and in 2019, approximately 463 million adults were living with diabetes by 2045; this will increase to 700 million (10.9%). India is a diabetic capital of world, prevalence of diabetes in India is 8.3%. This study aimed to assess self-care practices (SCPs) among type 2 diabetes mellitus (T2DM) patients, its predictors, and effect of SCP on glycemic control. A cross-sectional hospital-based study was conducted among 300 known T2DM patients in the age group of 18-60 years attending noncommunicable diseases clinic at Secondary and Tertiary Care Hospitals of Lucknow, Uttar Pradesh, selected using two-stage purposive sampling method. Data were collected using a predesigned and pretested semi-structured questionnaire. Data were collected from consenting respondents on the sociodemographic profile (about their residence, gender, marital status, type of family, educational status, family income, employment status, etc.). SCP was assessed using Summary of Diabetes Self-Care Activities. Data were analyzed using SPSS. Among 300 patients with a mean age 50 ± 8.9 years, the prevalence of good SCPs was 37%. Out of 189 T2DM patients with poor SCPs, 66.4% had uncontrolled blood sugar level (285.4 ± 67 mg/dL). Out of 73 T2DM patients with poor SCPs, 65.7% had uncontrolled glycated hemoglobin level (8.4% ± 2%), and this was statistically significant. The practice of self-care was found to be suboptimal among patients with T2DM in the study.

1242-P: Prevalence of Newly Detected Diabetes and Glycemic Status of People with Diabetes Already on Treatment: Results from a Nationwide Community Screening Program by RSSDI.

Background: Several studies have suggested that prevalence of diabetes in India is increasing, a large number of people remain undiagnosed, and overall glycemic control is poor among patients with diabetes. Although there is paucity of data from large population studies. Current study was aimed at analyzing the data collected during the One Nation, One Day, One Million Tests campaign by the Research Society for the Study of Diabetes in India (RSSDI) Methodology: Data collected from the One Nation, One Day, One Million Tests campaign by the Research Society for the Study of Diabetes in India (RSSDI) was retrospectively analyzed. A total data of 225955 adults was included in the analysis out of which 142391 (63%) were males while 83564 (37%) were females. Results: 78694 (34.8%) subjects reported to have preexisting diabetes while 21380 (9.5%) were detected to have diabetes for the first-time during the screening program. Total prevalence of diabetes in the cohort was 100074 (44.3%) . Among people with preexisting diabetes, 68669 (87.3%) reported to be on treatment for diabetes. 17646 of them presented in fasting state and 14834 (21.6%) of them had fasting sugar above 130 mg/dl. Random blood sugar was tested for 423diabetic subjects on treatment, out of which 28335 (41.3%) had random blood sugar more than 180 mg/dl. Overall, 62.9% (43169) of diabetes patients on treatment had their blood sugar values beyond target range. Conclusions: High prevalence of newly detected diabetes in the cohort re-emphasizes the need for aggressive screening for early detection of diabetes in the Indian population. Although the number of people who reported to be on treatment for diabetes was better in this cohort compared to earlier studies, only one third of these subjects had their sugar levels under control. Disclosure R.M.Parikh: None. R.R.Kovil: None. P.M.Chawla: Speaker's Bureau; Biocon, Boehringer Ingelheim International GmbH, Eris Lifesciences Ltd., Novo Nordisk, Sanofi. A.Gupta: Speaker's Bureau; Lupin Pharmaceuticals, Inc., Medtronic, Novartis AG, Novo Nordisk, Sanofi. B.D.Saboo: None. V.K.Ch: None. S.Agarwal: Speaker's Bureau; Novo Nordisk, Roche Diabetes Care, Sanofi, USV Private Limited. B.M.Makkar: None. S.Bhattacharyya: None. S.Chittawar: None. A.Nanditha: None.

A PILOT STUDY TO ASSESS THE EFFECTIVENESS OF NURSE-LED HOME BASED DIABETES MANAGEMENT PROGRAM ON QUALITY OF LIFE (QoL) AND SELF MANAGEMENT OF PEOPLE LIVING WITH TYPE 2 DIABETES RESIDING IN RURALAREAS OF AMBALA DIST, HARYANA

The prevalence of diabetes in India is increasing day by day. The standards of diabetes care in rural areas of India needs strengthening and the desired goal ofthe country isstillfarfromits achievement. Aims:The presentstudy aims(1)to determine the effectiveness of Nurse Led HomeBased Diabetes Management program (N-HBDMP) on people living withType 2 diabetes(PLD)in terms of Selfmanagement andQualityoflife (2)Tondrelationshipbetweenself-management andqualityoflifeofpeople livingwith Type2diabetes.(3)todetermine the association of self management and Quality of life with the selected demographic and clinical variables of PLD Method: A quantitative research approach with a pragmaticRandomizedControlledTrial(RCT) was used.The pilotstudy was conducted from15th March 2021 to 15th June, 2021 after obtaining ethical approval.Procedure:the data was collected on the 1st day and the 90th day using the DSMQ and the QOLID.Blood sample wastaken and sent toThyrocare lab for HbA1c andRBS was checked with glucometer. On the same day, intervention was given to intervention group.Every 15th day, the Intervention group were called on their phones and were reminded on their follow up and adherence to diabetes management. Control group received the routine care. Result: The data was analysed for 32 participants which showed there wassignicant increase in mean SD of diabetesself managementscore from 4.14(1.15)to5.48(0.46) andtheQualityoflife score100.4±(15.6)to129.7±(9.41)inthe interventiongroup(n-15),whichmeans thattheN-HBDMPinterventionwaseffectiveinenhancingSelfManagementandimprovingthequalityoflifeofpeoplelivingwithdiabetes.

Assessment of Vitamin A and Vitamin E Levels in Patients with Controlled and Uncontrolled Type 2 Diabetes Mellitus: A Case-control Study

Introduction: The prevalence of diabetes in India according to the International Diabetes Federation (IDF), Diabetes Atlas 2015 is reported to be 8.7%. Diabetes mellitus is a metabolic disorder, which results from body’s insensitivity to insulin and affects humankind at an alarming pose. Glycated Haemoglobin (HbA1c) is an important biomarker in assessing glucose level serologically. If HbA1c level is <7% the diabetes is said to be in controlled conditions. Vitamin A and E plays pivotal role as antioxidants in order to control oxidative stress which is an important contributing factor in diabetes mellitus by neutralising free radicals generated. Aim: To assess the antioxidants vitamin A and vitamin E levels in controlled and uncontrolled Type 2 Diabetes Mellitus (T2DM) patients and also to correlate the vitamin A and E levels with HbA1C in controlled and uncontrolled T2DM patients. Materials and Methods: The present case-control study was conducted for 12 months from January 2019 to December 2019 in the Department of Biochemistry, Jawaharlal Nehru Medical College Belagavi, Karnataka, India. The blood samples were collected from KLE’S Dr. Prabhakar Kore Hospital and Medical Research Center, Belagavi, Karnataka, India. A total of 110 subjects were divided into two group’s controlled Group 1 (55) and uncontrolled Group 2 diabetes (55) on the basis of HbA1c levels. Vitamin A and E levels were assessed by Enzyme Linked Immunosorbent Assay (ELISA) method. HbA1c was estimated by using Bio-Rad D-10 HbA1c program. The data was assessed using Chi-square test, Independent t-test, and Karl-Pearson corelation test. Results: There were a total of 29 males and 26 females in controlled T2DM group and a total of 34 males and 21 females in uncontrolled T2DM group. The mean ages in controlled and uncontrolled T2DM subjects were 57.11±8.82 years and 54.22±7.93 years respectively. The HbA1c (%), vitamin E and vitamin A in controlled T2DM subjects were 6.01±0.56 years, 1.01±0.43 years and 21.66±7.94 years respectively. The HbA1c (%), vitamin E and vitamin A in uncontrolled T2DM subjects were 9.31±0.25 years, 0.58±0.29 years and 14.66±5.36 years respectively. Corelation of vitamin A and E with HbA1c was found to be non significant statistically. Conclusion: Vitamin A and E levels were comparatively higher in controlled diabetes patients in comparison to uncontrolled T2DM patients.

Prescribing patterns in type 2 diabetes mellitus outpatients at a tertiary care centre in Jaipur, India

Background: Over the last few years, an unexpected increase in the prevalence of diabetes in India have been witnessed. The present study was planned to analyse prescribing patterns of anti-hyperglycaemic drugs and assess the influence of Chief Minister's Free Drug Scheme in Rajasthan, India. It aimed to evaluate, monitor and if possible, suggest modifications in prescribing practices to make medical care rational and also to assist minimising adverse drug reactions (ADRs). Methods: This was a cross-sectional, observational study carried out for a 12-month period. A total 400 known patients of type 2 diabetes mellitus (T2DM) from endocrinology outdoor of SMS Medical College Hospital (a tertiary care hospital in Jaipur, Rajasthan, India) were recruited and their prescriptions were analysed using the World Health Organization (WHO) prescribing indicators. Results: Most commonly observed age group was of 40-50 years (mean age 53.76 ± 8.84), with a male preponderance (57.5 %). Among them, 67.5 % of patients were found to be obese (mean BMI 29.79 ± 3.26). All anti-hyperglycaemic were prescribed in their generic names only. Metformin was the most frequently prescribed anti-hyperglycaemic agent. Among the fixed dose combinations, the most common was that of glimepiride and metformin (40.75 %), while most prescribed add on anti-hyperglycaemic was teneligliptin (51.5 %), followed by pioglitazone (30.5 %). A total of 53.25 % of these patients received insulin along with oral anti-hyperglycaemic agents. Conclusion: The anti-hyperglycaemic agent prescribing among endocrinology outpatients at tertiary care hospital in Jaipur was found to be satisfactory.

Clinical Learning Environment: Experience of Nursing Students

Aim: This study is conducted to assess factors interfering with good and poor glycemic control. Introduction: There is a rising trend in the prevalence of diabetes in India over recent years, poor and inadequate glycemic control affected by many factors such as socio-demographic, clinical and behavior factors constitutes a major risk factor for the development of diabetes complications. Materials and Methods: A descriptive study was conducted using purposive sampling technique by enrolling 100 subjects with type 2 Diabetes Mellitus having 30 and above 30 years of age, attending OPD or admitted in SGRD hospital. Data collected by observation and interviewing the subjects using self-structured questionnaire. Analysis and interpretation were done by descriptive and inferential statistics. Results: It shows that total of 100 subjects 61% had poor and 39% had good glycemic control. Factors such as age 50–59 years 18 (29.5%), male 36 (59%), informal education 30 (49.1%), BMI overweight 27 (44.3%), duration of diabetes 4–6 years, 30 (49.2%), and co-morbidities such as hypertension 38 (62.3%) and renal diseases 20 (32.8%), inappropriate diabetic diet 37 (60.7%), and 35 (57.4%) inadequate exercise alcohol consumption 26 (42.6%) were factors interfering glycemic control. Complications related to diabetes were 10 (16.4%) retinopathy and nephropathy, 23 (37.7%) neuropathy, 4 (6.6%) coronary artery disease, 8 (13.1%) foot ulcer, 15 (24.6%) stroke, 5 (8.2%) cataract and their odd ratios (OR-3.627, 7.45, 48.22, 6.18, 12.55, 18.09, 3.913, and 1.07, respectively). Conclusion: There is need to achieve an understanding of the extent of glycemic control in patients with type 2 DM and to see the factors interfering with good and poor glycemic control groups, and as a result, to spot the factors affecting glycemic control

A Descriptive study to assess the Factors interfering with Glycemic Control among Type 2 Diabetes Mellitus patients

Aim: This study is conducted to assess factors interfering with good and poor glycemic control. Introduction: There is a rising trend in the prevalence of diabetes in India over recent years, poor and inadequate glycemic control affected by many factors such as socio-demographic, clinical and behavior factors constitutes a major risk factor for the development of diabetes complications. Materials and Methods: A descriptive study was conducted using purposive sampling technique by enrolling 100 subjects with type 2 Diabetes Mellitus having 30 and above 30 years of age, attending OPD or admitted in SGRD hospital. Data collected by observation and interviewing the subjects using self-structured questionnaire. Analysis and interpretation were done by descriptive and inferential statistics. Results: It shows that total of 100 subjects 61% had poor and 39% had good glycemic control. Factors such as age 50–59 years 18 (29.5%), male 36 (59%), informal education 30 (49.1%), BMI overweight 27 (44.3%), duration of diabetes 4–6 years, 30 (49.2%), and co-morbidities such as hypertension 38 (62.3%) and renal diseases 20 (32.8%), inappropriate diabetic diet 37 (60.7%), and 35 (57.4%) inadequate exercise alcohol consumption 26 (42.6%) were factors interfering glycemic control. Complications related to diabetes were 10 (16.4%) retinopathy and nephropathy, 23 (37.7%) neuropathy, 4 (6.6%) coronary artery disease, 8 (13.1%) foot ulcer, 15 (24.6%) stroke, 5 (8.2%) cataract and their odd ratios (OR-3.627, 7.45, 48.22, 6.18, 12.55, 18.09, 3.913, and 1.07, respectively). Conclusion: There is need to achieve an understanding of the extent of glycemic control in patients with type 2 DM and to see the factors interfering with good and poor glycemic control groups, and as a result, to spot the factors affecting glycemic control

Nutritional Transition and Associated Epidemiological Transition in India

Overnutrition and associated health risks are no longer confined to high-income countries and have now become an emerging problem among the low- and middle-income countries. In India, overweight and obesity prevalence has doubled amongst men and has become more than one and a half times amongst women over a ten-year period, 2005 – 2015. The increase in overnutrition at state level is even more striking, with some states experiencing more than 100% increase in the prevalence of overweight and obesity during the above period. Overnutrition is linked to increase in the health burden in the form of rise in non-communicable diseases such as diabetes, cardiovascular diseases, heart strokes, certain type of cancers, etc. This article examines the recent trends in overnutrition and prevalence of diabetes in India and analyses the effects of overnutrition on diabetes considering state level data. Our analysis suggests that India is experiencing a nutritional transition with more than 24 states and union territories having higher overnutrition prevalence as compared to undernutrition prevalence. Diabetes has been rising in India, and our empirical analyses finds that a rise in overweight and obesity prevalence adversely affects diabetes prevalence. Important finding is that the marginal effect of a rise in obesity prevalence on diabetes is are more than twice than that for overweight and obesity prevalence suggesting that higher BMI values further elevates the risk of diabetes. These results suggest that the nutritional transition in India is leading to an epidemiological transition.

Diabetic retinopathy screening guidelines in India: All India Ophthalmological Society diabetic retinopathy task force and Vitreoretinal Society of India Consensus Statement.

Diabetic retinopathy (DR) is an emerging preventable cause of blindness in India. All India Ophthalmology Society (AIOS) and Vitreo-Retinal Society of India (VRSI) have initiated several measures to improve of DR screening in India. This article is a consensus statement of the AIOS DR task force and VRSI on practical guidelines of DR screening in India. Although there are regional variations in the prevalence of diabetes in India at present, all the States in India should screen their population for diabetes and its complications. The purpose of DR screening is to identify people with sight-threatening DR (STDR) so that they are treated promptly to prevent blindness. This statement provides strategies for the identification of people with diabetes for DR screening, recommends screening intervals in people with diabetes with and without DR, and describes screening models that are feasible in India. The logistics of DR screening emphasizes the need for dynamic referral pathways with feedback mechanisms. It provides the clinical standards required for DR screening and treatment of STDR and addresses the governance and quality assurance (QA) standards for DR screening in Indian settings. Other aspects incorporate education and training, recommendations on Information technology (IT) infrastructure, potential use of artificial intelligence for grading, data capture, and requirements for maintenance of a DR registry. Finally, the recommendations include public awareness and the need to work with diabetologists to control the risk factors so as to have a long-term impact on prevention of diabetes blindness in India.

Prevalence of prediabetes, and diabetes in Chandigarh and Panchkula region based on glycated haemoglobin and Indian diabetes risk score.

There is a rapid increase in the prevalence of diabetes in India. We wanted to review the status of prediabetes and diabetes in the combined population of Chandigarh and Panchkula region based on both Indian Diabetes Risk Score (IDRS) and Glycated Haemoglobin (HbA1c). A total of 1215 subjects were recruited during the screening process, out of which 444 i subjects have been analysed for the current study on the basis of high risk for IDRS (≥60) and their known diabetes status. This study included 431 subjects having high risk for IDRS (≥60) and 13 known subjects with diabetes (IDRS < 60) which were further analysed for biochemical and anthropometric parameters. The prevalence of diabetes was found to be 12.67% and prediabetes 11.69% in the combined population of Chandigarh and Panchkula. There was an increased level of fasting blood glucose (183.12 ± 68.61), postprandial blood glucose (262.57 ± 96.92), triglyceride (193.84 ± 119.88), very low‐density lipoprotein (VLDL) (34.87 ± 15.42) and High Density Lipoprotein(HDL) (4.61 ± 1.39) in the said diabetes population. Mean HDL was found to be decreased in subjects having diabetes. Glucose‐induced lipid intolerance study revealed significant alteration in triglyceride, HDL and VLDL. The study has revealed that high prevalence of diabetes in the sampled population when compared with the national average of 8.8%.

Associations between air pollution and built environment on insulin resistance and HbA1c in the PURSE-HIS Cohort.

Background: India is undergoing rapid urbanization with simultaneous increases in air pollution exposures and cardio-metabolic health. Here we assess associations between fine particulate matter (PM2.5) two measures of the built environment and insulin resistance (IR) and hemoglobin A1c (HbA1c) in the Population study of Urban, Rural, Semi-urban Endovascular disease and Holistic Intervention Study (PURSE-HIS) in Tamil Nadu, India. Methods: We performed cross-sectional analysis of 6246 randomly selected participants without diabetes (mean age 42 years; 58% women). IR was assessed by homeostasis model assessment of IR (HOMA-IR); HbA1c was assessed by high-performance liquid chromatography. We used estimates developed for Global Burden of Disease to assign annual average exposure to PM2.5. Exposure to the built environment were assigned using satellites: MODIS derived normalized difference vegetation index (NDVI), a measure of vegetation health and greenness; and DMPS-OLS derived nighttime lights (NTL). Multivariable regression models were used to assess associations between built environment measures and IR and HbA1c, adjusting for age, BMI, cook fuel type, energy intake, physical activity, sex, smoking, and socioeconomic status. Results: Residing in areas with higher PM2.5, NTL and lower greenness were associated with elevated HOMA-IR, and HbA1c. An interquartile range change in PM2.5 (IQR = 3.0 µg/m3) was associated with a 0.29 mg/dl (95%CI: 0.22, 0.37) increase in HOMA-IR. Built environment measures of greenness (IQR = 0.18) was associated with a -0.17 mg/dl (95%CI: -0.24, -0.09) decrease in HOMA-IR and a -0.21% (95%CI: -0.31%, -0.12%) change in HbA1c. An IQR change in NTL (IQR = 0.08) was associated with a decrease in HOMA-IR but was not significant for HbA1c. Conclusions: PM2.5 and NTL were associated with increased HOMA-IR, while increased exposure to greenness decreased HOMA-IR and HbA1c suggesting potential pathways by which factors rapid urbanization could be associated with increased prevalence of diabetes in India.

Geographic Variation and Associated Covariates of Diabetes Prevalence in India

Diabetes is a severe metabolic disorder affecting human health worldwide, with increasing prevalence in low- and middle-income countries. Gaps in knowledge regarding factors that lead to diabetes and its association with tuberculosis (TB) endemicity at the national scale still exist, mainly because of the lack of large-scale dual testing and appropriate evaluation methods. To identify locations in India where diabetes prevalence is concentrated, examine the association of diabetes with sociodemographic and behavioral covariates, and uncover where high regional TB endemicity overlaps with diabetes. This cross-sectional study included 803 164 men aged 15 to 54 years and women aged 15 to 49 years who participated in the Demographic Health Survey (2015-2016), carried out by the India Ministry of Health and Family Welfare using a 2-stage clustered sampling, which included a diabetes estimation component. The survey was conducted from January 2015 to December 2016, and data analysis was conducted from July 2018 to January 2019. Self-reported diabetes status. Self-reported diabetes status was used to estimate the association of covariates, including educational level, sex, age, religion, marital status, alcohol use, tobacco use, obesity status, and household socioeconomic level, with diabetes prevalence. Additionally, regional tuberculosis endemicity level, estimated using the India TB report for 2014 from the Revised National TB Program, was included to evaluate the national extent of the spatial overlap of diabetes and TB. Among 803 164 sampled individuals (691 982 [86.2%] women; mean [SD] age, 30.09 [9.97] years), substantial geographic variation in diabetes prevalence in India was found, with a concentrated burden at the southern coastline (cluster 1, Andhra Pradesh and Telangana: prevalence, 3.01% [1864 of 61 948 individuals]; cluster 2, Tamil Nadup and Kerala: prevalence, 4.32% [3429 of 79 435 individuals]; cluster 3, east Orissa: prevalence, 2.81% [330 of 11 758 individuals]; cluster 4, Goa: prevalence, 4.43% [83 of 1883 individuals]). Having obesity and overweight (odds ratio [OR], 2.44; 95% CI, 2.18-2.73; P < .001; OR, 1.66; 95% CI, 1.52-1.82; P < .001, respectively), smoking tobacco (OR, 3.04; 95% CI, 1.66-5.56; P < .001), and consuming alcohol (OR, 2.01; 95% CI, 1.37-2.95; P < .001) were associated with increased odds of diabetes. Regional TB endemicity and diabetes spatial distributions showed that there is a lack of consistent geographical overlap between these 2 diseases (eg, TB cluster 4: 60 213 TB cases; 186.79 diabetes cases in 20 183.88 individuals; 0.93% diabetes prevalence; TB cluster 8: 47 381 TB cases; 180.53 diabetes cases in 22 449.18 individuals; 0.80% diabetes prevalence; TB cluster 9: 37 620 TB cases, 601.45 diabetes cases in 12 879.36 individuals; 4.67% diabetes prevalence). In this study, identifying spatial clusters of diabetes on the basis of a nationally representative survey suggests that India may face different levels of disease severity, and each region might need to implement control strategies that are more appropriate for its unique epidemiologic context.

Prevalence of microalbuminuria with associated risk factors among diabetics in the urban field practice area of a medical college in Muzaffarnagar, Uttar Pradesh

Background: Diabetes is a major threat to global public health that is rapidly getting worse and its biggest impact is on adults of working age 45-55 in developing countries. Diabetes mellitus causes progressive changes to the kidneys and ultimately results in diabetic nephropathy. Microalbumin measurement is useful in diagnosis at an early stage, before the development of proteinuria.Methods: This is a community based cross sectional study. The study period of 2 months, from September 2019 to October 2019. Adult between 20 to 59 years of age at the time of data collection from house to house visit were included in the study. A total of 138 diabetics were found in the community and accessed for microalbuminuria and other risk factors.Results: Prevalence of microalbuminuria among was 15.1%. Logistic regression model analysis revealed that micro albuminuria was significantly correlated with the diastolic blood pressure (p=0.003) and the duration of diabetes (p=0.001).Conclusions: Due to the high prevalence of diabetes in India we need to screen all diabetics for microalbuminuria. Control of blood pressure should also be done more vigorously in diabetic patients.