Assessment of risk of diabetes by using Indian Diabetic risk score (IDRS) in Indian population

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Abstract

Aims

To screen the Indian population for Type 2 Diabetes Mellitus (DM) based on Indian Diabetes Risk Score. Our main question was; Does Indian Diabetic risk score (IDRS) effectively screen diabetic subjects in Indian population?

Methods

Multi-centric nationwide screening for DM and its risk in all populous states and Union territories of India in 2017. It is the first pan India DM screening study conducted on 240,000 subjects in a short period of 3 months based on IDRS. This was a stratified translational research study in randomly selected cluster populations from all zones of rural and urban India. Two non-modifiable (age, family history) and two modifiable (waist circumference & physical activity) were used to obtain the score. High, moderate and low risk groups were selected based on scores.

Results

In this study 40.9% subjects were detected to be high risk, known or newly diagnosed DM subjects in urban and rural regions. IDRS could detect 78.1% known diabetic subjects as high risk group. Age group 50–59 (17.4%); 60–69 (22%); 70–79 (22.8%); >80 (19.2%) revealed high percentage of subjects. ROC was found to be 0.763 at CI 95% of 0.761–0.765 with statistical significance of p < 0.0001. At >50 cut off, youden index showed the sensitivity of 78.05 and specificity of 62.68. Regression analysis revealed that IDRS and Diabetes are significantly positively associated.

Conclusions

Data reveals that IDRS is a good indicator of high risk diabetic subjects.

Section snippets

Introduction:

As per the International Diabetes Federation (IDF), the number of people with Type 2 Diabetes (DM) is increasing in each country. Currently, 387 million people are living with Diabetes across the world, and it is expected to rise to a whopping figure of 592 million in 2035 [1]. In the year 2000, India had highest number of DM patients followed by china and US. This DM patient population is expected to increase to 79.4 million by 2030 in India [36]. Co-morbidities associated with Diabetes and

Results

Demographic Details: Pan-India, a total of 240,000 individuals were recruited for screening based on IDRS. Demographical details including age, sex, Body-mass Index, Waist circumference, socio-economic Status have been tabulated in Table 2.

Zone wise prevalence: Zone wise prevalence was estimated 40.9% prevalence of high risk, whether known or newly diagnosed DM subjects, in urban (23.1%) and rural (17.8%) regions. Moreover, 29.7% populations were found to have moderate risk for DM. Regions

Discussion

IDRS is one of the cost-effective methods to detect the DM risk among the Indian population.[8], [16] This is the first nationwide study on 240,000 population conducted within 3 months in all zones of India. Based on IDRS data, we report that 40.9% & 29.7% of known DM subjects fall in high risk and moderate risk groups, respectively. This increased to 78.1% among the known subjects. However, North western J&K and south Indian zones were found to be affected. In a Lucknow based study, conducted

Funding

This research was funded by Central Council for Research in Yoga and Naturopathy (CCRYN), New Delhi (Ref F.No. 16-63/2016-17/CCRYN/RES/Y&D/MCT/Dated: 15.12.2016).

Declaration of Competing Interest

None exists.

Acknowledgement

We acknowledge Ministry of AYUSH, Govt of India, New Delhi, for funding this project. We also acknowledge support of CCRYN for manpower, MOHFW for supporting the cost of investigations and IYA for the overall project implementation. We thank the advisory research committee, senior research fellows, Mr Sabzar, Dr Sanjay, Ms Radhika, Dr Sunanda Rathi, Yoga volunteers and the President of Indian Yoga Association for their contribution in this project.

Author contributions

R.N. and H.R.N. Conceptualization, Data Curation and acquisition, Funding Acquisition, Supervision R.N. and A.S. Formal Analysis, Investigation, Methodology, Validation and Writing—review and editing. R.T. and P.B. Drafting of the Original draft, critical review and editing. A.A. Concept of manuscript.

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    Co-Corresponding author at: Neuroscience Research Lab, Department of Neurology, PGIMER, Chandigarh, India.

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