IJCRR

IJCRR - 13(1), January, 2021

Pages: 10-15

Date of Publication: 05-Jan-2021

Prevalence of Diabetes Mellitus and Socio-demographic Survey in the Community of Western Uttar Pradesh, India in the Year 2019-2020

Author: Nadeem Rais, Akash Ved, Rizwan Ahmad, Kehkashan Parveen, Om Prakash

Category: Healthcare

Abstract:Introduction: Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose, which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. There are two types of diabetes and the most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or doesn't make enough insulin.
Objective: This study aimed to estimate the prevalence of diabetes mellitus (DM) and its socio-demographic profile and screen the study population of diabetic patients in Western Uttar Pradesh.
Methods: The different mode of the survey was conducted between January 2019 to January 2020. A random screening was carried out with 3989 individuals of 1000 families at various geographical regions of western Uttar Pradesh. This was a cross-sectional house to house experience study that was conducted to find out the prevalence of diabetes mellitus at the community level.
Result: A total of 287 diabetic subjects were enrolled through a simple random sampling methodology. In the collected data, the prevalence of DM was found at 07.34%. Whereas the prevalence of type-1 DM and type-2 DM amongst known diabetics was found 06.62% and 93.37% respectively.
Conclusion: Incidents of DM were found varied person to person depending on their physical activities, knowledge, and myths/misconceptions about diabetes, food habits, etc. Current findings suggest that a relatively unfavourable risk profile of the diabetic subjects who also suffered from diabetic complications.

Keywords: Diabetes Mellitus, Prevalence, Community, Demographics profile, Uttar Pradesh

Full Text:

INTRODUCTION

Diabetes is a chronic problem that occurs either when the insulin production decreases from β cells of islets of Langerhans or when the pancreas cannot effectively use the insulin it produces. Insulin is a peptide hormone produced by beta cells of the pancreatic islets that regulates blood sugar level in the body. Hyperglycaemia, or raised blood sugar level, is the most common problem of uncontrolled diabetes and over time leads to serious damage to many of the body's systems, especially the nerves and blood vessels.^1,2

India is currently experiencing a rapid epidemiological transition from communicable to non-communicable diseases viz. diabetes mellitus, hypertension, and ischaemic heart disease. Rapid industrialization and urbanization with a subsequent rise in standards of living, obesity, stress, sedentary lifestyle, addictions, etc. are posing a growing threat to the health of the nation. The number of people with diabetes in India currently around 40.9 million is expected to rise to 69.9 million by 2025 unless urgent preventive steps are taken.² A very high prevalence of DM was observed in Saudi Arabia, the U.S., Switzerland, and Austria. Researchers believe there is a 250 per cent greater incidence of DM in the Middle East, Sub-Saharan Africa, India, Asia, and Latin America.³

Over recent decades, the prevalence of diabetes mellitus has been increasing worldwide due to factors like changes in lifestyle (sedentary living and eating habits) and obesity.^4,5 The World Health Organization (WHO) estimated that India will have the largest number of diabetics in the world (every fourth diabetic is an Indian) and will become the diabetic capital of the world. ^6,7,8 Although it has been recognized as a major cause of death and disability, many who suffer from diabetes are unaware that they are afflicted until they experience a debilitating side effect or complication of the disease.⁶ It is a fact that good clinical and self-care activities can delay diabetic complications and improve the quality of life. Therefore, in this present research, we attempted to determine the prevalence of diabetes mellitus and its socio-demographic profile and screen the study population of diabetic subjects in Western Uttar Pradesh.^9-13 Having diabetes increases the risk of a myocardial infarction two times and the risk of suffering a stroke two to four times and it is also a leading cause of blindness, limb amputation, and kidney failure.^14-16

MATERIALS AND METHODS

Study population

This was a cross-sectional house to house experience study that was conducted to find out the prevalence of diabetes mellitus at the community level. The study was carried out in the urban, semi-urban, and rural areas of Western Uttar Pradesh, India. Some developing and developed cities viz. Ghaziabad, Meerut, Bijnor, J.P. Nagar, and Moradabad of western Uttar Pradesh were selected for the study. The survey started in January 2019 and concluded in January 2020. The research protocol was approved by independent ethics committees. A random survey was performed with a total population of 3989 individuals Ghaziabad (N1=406), Meerut (N2=603), Bijnor (N3=1123), J.P. Nagar (N4=876), and Moradabad (N5=981) from 1000 families to know whether they had diabetes or not. The family members of already registered diabetic patients under treatment (oral antidiabetic drugs/injection regimen) or discontinuation were studied consciously (excluding pregnant women). 293 diabetic patients were selected for the study while 6 diabetic patients declined to answer any queries regarding diabetes. In this context, the detailed study of present final data of 287 diabetic patients of both gender and either age were carried out.

Data collection method

Data of the total population were collected on individual Data Collection Forms1 (DCFs1) while data of diabetic patients were collected on individual Data Collection Forms2 (DCFs2) at baseline and written consent was obtained from all the patients participating in the study. DCFs1 included in the interview schedule pertained to personal information i.e. name, religion, age/gender, residence, marital alliance, and diabetic status. DCFs2 included in the interview schedule pertained to personal information, date of diagnosis of disease, patient’s medical history, knowledge and myths/ misconceptions about diabetes, diabetic complication, demography, education, occupation, antidiabetic treatment, food habits, blood glucose measurement frequency, diabetes among any family member, number of hypoglycaemic episodes, adverse drug reactions (ADRs) and lifestyle (i.e. physical activity, smoking or consumption of alcohol, etc.).^17-19

Data handling and statistical analysis

All data were tabulated and descriptive statistical analyses were performed. Sub groupings were carried out where required and prevalence (%) was calculated. Values are expressed as mean±SEM (N=5) by using One-way Analysis of Variance (ANOVA) followed by Dunnett's Multiple Comparison Test P< 0.01.

RESULTS

Data Concerning the prevalence of diabetes according to gender, marital alliance, and type incidence amongst known diabetics with Prevalence of DM according to parental history is presented in Table 1.

There are 3989 individuals from 1000 families in the five zoographical regions of Ghaziabad (406), Meerut (603), Bijnor (1123), J.P. Nagar (876), and Moradabad (981)} were selected for the study. The patients taken medications by oral ant-diabetic drugs/injection regimen under the supervision of physicians and discontinuation were studied consciously (excluding pregnant women). 293 diabetics were selected for the study while 6 diabetic patients declined to answer any queries regarding diabetes. This gave a final sample of 287 diabetic patients (considered as 100%) of both gender and either age to be studied. Out of 287 diabetics, 278 were found married with a percentage of 56.09% (males) and 40.76% (females). Type-1 and Type-2 incidence amongst known diabetics were06.62% and93.37% respectively. Parental history of diabetes was detected 33.79% (either parent) and 09.05% (both parents) while 57.14% diabetics were detected without any family history of diabetes. The prevalence of diabetes was significantly different between different zoographical zones urban 51.21%, semi-urban 32.75%, and rural 16.02%. The detailed descriptions are reported in Table 2.

Diabetics in the study were distributed into 8 groups according to age (in years) from 21 to 70 plus, where we found that the age group of 21-27 was at the lowest risk (3.13%) of DM and the prevalence of diabetes increased significantly with advancing age till the age group of 42-48 (21.60%) then after this age group the prevalence of diabetes decreased significantly with advancing age (70+ years). The decreasing prevalence of DM after 54 years indicates the lethal effects of diabetes if not controlled. Detailed information is provided in Table 3.

Complications in DM were recorded and data were collected for the number of patients having one major complication, the number of patients with more than one complication, and the number of patients without any complication. The significant complications of diabetes were recorded as kidney disease, high blood pressure, neurological disorder cardiac disease, ophthalmic trouble, diabetic coma, etc, while 13.58% diabetics were reported without any complication. The detailed complications are reported in Table 4. Most of the diabetics were recorded as no exercise and sedentary work and data are 143 or 49.82%, while few diabetic peoples were aware of it and doing exercise regularly with strenuous work and data is 37 or 12.89%. Many of them accepted that physical activity plays a very important role in managing diabetes mellitus and found either doing regular exercise or strenuous work and data are 107 or 37.28%. The prevalence of DM according to lifestyles such as fast food/junk food (67.24%), smoking (35.54%), and consumption of liquor (4.52%) were recorded and detailed information is given in table5).

Out of 287 diabetics, patients are also elaborated based on literacy are having secondary school education, primary school education, college education, university/professional education, and illiterate patients and the collected data are 24.04%, 22.29%, 13.58%, 6.62%, and 18.81% respectively ( Table 6 and 7). The detailed information is reported in table 6. Out of 287 (100%) diabetics, the majority of subjects were found to have physically less active occupation like desk job (19.86%) > professional jobs (18.46%) > household work (18.11%) and further the prevalence was found gradually decreased with a physically active occupation like a businessman (15.33%) > labour (13.24%) > student (04.18%) while diabetics with other occupations were (10.80). The detailed information is given in Table 7. Because the majority of diabetics were uneducated or little educated, the prevalence of myths or misconceptions about diabetes mellitus was also at its peak. Out of 287 (100%) diabetics, 94(32.75%) subjects believed that excessive consumption of sweets is the main cause of DM. 91 (31.70%) subjects had negative faith that a diabetic lives no longer. 51 (17.77%) subjects were suggested to have relaxed. Despite this technical era, 26 (09.05%) subjects had faith in the spiritual treatment to get permanent benefit and25 (08.71%) diabetics thought that diabetes is contagious, and shown in Table 8.

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