Prevalence of Diabetes mellitus in the urban population of Jabalpur district, India

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1 Prevalence of Diabetes mellitus in the urban population of Jabalpur district, India Nusra Mustafa 1 and Sandeep Kushwaha 2* 1 RG Stone Urology & Laparoscopy Hospital F-12, East of Kailash, New Delhi , India 2 Zoological Survey of India, Central Zone Regional Centre, Scheme No. 5, , Vijay Nagar, Jabalpur Madhya Pradesh, India * sandeepkushwaha_17@yahoo.com India, the world s second most populous country, now has more people with type 2 diabetes (more than 50 million) than any other nation. The prevalence of diabetes has been well documented in a battery of recent papers (Shaw et al., 2010; Ramachandran, 2010). These publications were foreshadowed by studies of previously westernized Indian populations elsewhere, and they illuminate distinctive features of diabetes in India. Type 2 diabetes results from a genetic predisposition and from lifestyle factors, especially those of the socalled western lifestyle, characterized by high calorie intake and little exercise. Also known as non-insulin-dependent or adultonset diabetes, this form of the disease is far more common than type 1(insulin dependent or juvenile-onset) diabetes. Until recently, type 2 diabetes was viewed as a disease of overfed, sedentary people of European ancestry. But it is now exploding around the world owing tothe spread of Western habits. In India, a wide range of outcomes for different groups is buried within the average diabetes prevalence of 8% (Mohan et al. 2007,2008b). Prevalence is only 0.7% for non-obese, physically active, rural Indians. It reaches 11% for obese, sedentary, urban Indians; and it peaks at 20% in the Ernakulam district of Kerala, one of India s most urbanized states. Among lifestyle factors predicting the incidence of diabetes in India, some are familiar from the West; whereas others turn expectations upside down (Mohan et al. 2008a). In India, as in the West, diabetes is ultimately due to chronically high levels of blood glucose, and some of the clinical consequences are similar. The age of onset in India has been shifting towards every younger people even within the past decade among Indians in their late teens, adultonset diabetes already manifests itself more often than does juvenileonset diabetes. Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Depending on the etiology of the DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization, and increased glucose production (Power et al. 2008). There are an estimated 40 million persons with diabetes in India in 2007 and this number is predicted to rise to almost 70 million people by 2025 by which time every fifth diabetic subject in the world would be an Indian (Sicree et al. 2006). Regular screening of adults is essential for early detection and care. The objective of the study was to find out the prevalence of diabetes in the urban population of Jabalpur District, present study also finds out the diabetes in different age groups, educational status. A cross-sectional household survey was conducted among adults (20-60 years) in various localities of Jabalpur district viz., Wright town, Nepear town, Vijay Nagar, adhartaal, Hanumantal, Gorakhpur, Laborchowk and Sadar area. A structured 364

2 questionnaire was used to assess the knowledge of diabetes and capillary blood screening tests were done to detect the diabetes. Basic data regarding awareness, knowledge, traditional beliefs, treatment practices and other issues were included in the questionnaire. All households in the selected areas were visited and men and women were interviewed in alternate households and total of 122 samples were drawn. The study instrument was based on the STEPS approach of WHO. It included questions related to lifestyle activities like smoking, alcohol intake, diet, physical activity and history of treatment for hypertension and diabetes mellitus. Height, weight, waist circumference and blood pressure were measured. The study was carried out for a period of 9 months on every Saturday and Sunday (36 days) for collection of more data. Data was studied at R. G. Stone Hospital, New Delhi and analyzed with help of literature available in Research and Development wing. The survey revealed that 289 males and 221 females with type 2 diabetes in the urban population of the district. Out of 510 subjects examined, maximum persons 156 were in years age group, followed by 98 from years age group, however only 17 were belonging to 60 year and above.the educational status of the population was also studied. Around 38 subjects were illiterate. It was shown that awareness about diabetes was much better in College going and Professionals than illiterate and primary passed persons. Myth about the cure of diabetes was highest in secondary and higher secondary persons. Prevalence of diabetes in urban population of various cities is discussed in table 3. The prevalence of diabetes assessed in various localities of Jabalpur district revealed that the prevalence was highest in Wright town area i.e. 18% and lowest in Aadhartaal area i.e. 11% among eight areas surveyed. Recent report of WHO-ICMR showed that prevalence of self-reported diabetes was 7.3% in the urban population. Prevalence of diabetes in India study (PIOSD), based on ADA criteria, the prevalence of diabetes in urban population was 4.7%. Most of the population of Wright town and Nepear town belongs to HIG (High income group), sedentary, western life style and high calorie diets, which lead to the prevalence of diabetes. Population in Adhartaal belonged to MIG (Middle income group) were also prone to diabetes but the intensity was less. CONCLUSION Present study intended to screen persons above 20 years for type 2 diabetes to find out the prevalence and sociodemographic profile of participants. Maximum prevalence of diabetes in current study was 18% which suggests higher prevalence of diabetes in Jabalpur and is very similar to prevalence of other developing cities. The prevalence was highest in Wright town area i.e. 18% and lowest in Aadhartaal area i.e. 11%. Such data are extremely important to plan the public health policies with specific reference to implementation of National diabetic control program. ACKNOWLEDGEMENTS The authors are thankful to Dr. K. Venkataraman, Director, Zoological Survey of India and Director, RG Stone Urology & Laparoscopy Hospital, New Delhi for providing necessary facilities and encouragement. 365

3 Table 1: Educational status of the studied population group S.No. Characteristics Male No. Female No. Total No. 1 Illiterate Primary Secondary Higher secondary College Professionals Table 2: Prevalence of Diabetes in various studied places S. No. Locality Prevalence 1 Wright town Nepeartwon, Vijay Nagar Adhartaal Hanumantal Gorakhpur Labor chowk Sadar area 12.5 Table 3: Prevalence of diabetes in urban India since 1971 Year Reference Place Prevalence (%) 1971 Tripathy et al Cuttack Ahuja et al Multicentre (ICMR) Gupta et al Multicentre Murthy et al Tenali Patel Bhadran Ramachandran et al Kudremukh Kodali et al Gangavathi Raoet al Eluru Ahuja et al New Delhi Wander et al Punjab Ramankutty et al Kerala Zargar et al Kashmir Ramachandran et al National Urban Diabetes Study 12.1 (NUDS) 2001 Misra et al New Delhi Sadikot et al Prevalence of Diabetes in India Study 5.6 (PODIS) 2003 Gupta et al Jaipur Agarwal et al Rajasthan Ramachandran et al Chennai

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