Prevalence, awareness, treatment and control of

diabetes study

1. Prevalence, Awareness, Treatment and Control of Diabetes Among Elderly Persons in an Urban Slum of Delhi Arvind Kumar Singh ,   Kalaivani Mani ,   Anand Krishnan ,   Praveen Aggarwal ,   Sanjeev Kumar Gupta Presented By Dr. Chetan Sharma

2. prevalence of diabetes suggested that nearly 3% of adults were diabetic in the year 2000, and this figure is projected to be nearly doubled by the year 2030* Diabetes also contributes to 5% of the total mortality .# demographic transition  is due to increase in the number of aged persons, leading to an increase in the prevalence of hypertension and diabetes .^

3. Undiagnosed diabetes is associated with increased risk of all-cause mortality.  Low-socioeconomic status is associated with development of diabetes.

4.  Materials and Methods This was a cross-sectional  study among elderly persons aged 60 years and above. The sample size was estimated based on a multicenter study carried out in 10 cities of India, which reported the prevalence of diabetes among the elderly persons as 13.4 %. All participants were interviewed in the local language, at their homes.

5. Fasting blood sugar was estimated using an Eukare   R  automated glucometer . Diabetes was diagnosed if the fasting blood glucose was ≥126 mg/ dL (≥7.0 mmol /L) after an overnight fast for at least 8 hours. The awareness status regarding their own diabetes mellitus was defined as having diabetes diagnosed by a health professional with presence of a prescription, or anti-diabetic medicines possessed by the participant.

6. The treatment status was defined as taking any pharmacological treatment for diabetes. Participants who were already diabetic and taking treatment were considered to have control if the fasting blood glucose was <126 mg/ dL . Of the 496 participants who were interviewed, 22 (4.4%) refused for fasting blood sugar estimation.

7. None of these 22 persons had any prescription for anti-diabetic medicines. Hence, fasting blood sugar testing was done in 474 (95.6%) of the 496 participants. Fifty-two percent of the participants were male. About four-fifths of the participants were aged less than 70 years  [Table 1] . The mean age was 65.0 years

8. Table 1: Demographic characteristics of the participants

9. The prevalence of impaired blood glucose was estimated to be 19.8% (95% CI 16.3-23.7). It was 19.2% (95% CI 14.4-24.7) and 20.5% (95% CI 15.5-26.3) among men and women, respectively. About one-third (36.0%) of the 89 diabetics were aware of their condition.

10. Of those participants who were aware, more than half were on treatment . Of those on treatment, three- fourth had controlled fasting blood sugar  [Table 3 ] .

11. Table 3: Participants with diabetes who were aware, treated and controlled

12. Discussion The prevalence of diabetes was estimated to be 18.8% in the present study . Studies from India have reported a prevalence from 13% to 25%, which is comparable . Decrease in the prevalence of diabetes with increasing age in the present study could be due to a survival bias.

13. On an average, every fifth elderly person was identified as having impaired fasting blood glucose.  This is a pre- diabetic condition .  institution of dietary and lifestyle modifications may prevent or delay progression to diabetes in this group.

14.  62.5% of those who were aware that they had diabetes were taking treatment . The awareness, treatment and control were better among women . Among elderly persons, the prevalence of diabetes was found to be comparable to previous reported estimates .  the awareness level in them regarding its presence was low .

15. Screening, diagnosis and proper treatment of diabetes is required for elderly persons.   Because they may be unable to visit the fixed health facility due to dependency on family members. Strengthening primary health care services in urban slums, with special emphasis on the vulnerable population like elderly persons, is needed.