Sharma Sarit, Bansal Aman, Singh Surinder Pal, Chaudhary Anurag, Satija Mahesh, Singla Ankur, Kalsi Harsimran
Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
J Family Med Prim Care. 2022 Nov;11(11):7077-7084. doi: 10.4103/jfmpc.jfmpc_1116_22. Epub 2022 Dec 16.
Diabetes is one of the leading killers among noncommunicable diseases of the present time and poses a considerable burden to the society in terms of public health. The Indian Diabetes Risk Score (IDRS) can be used as a risk assessment tool to estimate the population at risk and plan appropriate interventions. The present study was conducted to assess the diabetes risk profile of a rural population of Punjab by using IDRS.
This was a cross-sectional study conducted in two phases after obtaining approval from the Institutional Ethics Committee. Phase 1 was done in Rural Health Training Center (RHTC), Pohir, where every fifth patient attending the outpatient department was included in the study. Phase 2 was conducted in village Gopalpur, which is one of the villages in the field practice area of Department of Community Medicine, where participants were enrolled by conducting house to house survey after taking their informed consent. Sociodemographic characteristics, risk factor profile, and the IDRS of the participants were noted. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0 to calculate the percentages. Pearson's Chi-square test was used for qualitative variables, and mean, standard deviation and analysis of variance (ANOVA) were used for quantitative variables. A value of less than 0.05 was considered significant.
A total of 252 subjects (99 male and 153 female) from RHTC and 213 subjects (71 male and 142 female) from village Gopalpur participated in the study, with their mean IDRS being 44.8 ± 15.7 and 46.6 ± 21.1, respectively. On calculating the IDRS of participants enrolled in RHTC, it was found that 15.5% had low, 56% had moderate, and 28.5% had high risk, whereas from village Gopalpur, 19.2% had low, 57.3% had moderate, and 23.5% had high risk for developing diabetes mellitus. The risk for developing diabetes was found to be higher among females, subjects living in joint families, and subjects with high body mass index (BMI). The mean systolic and diastolic blood pressure showed an increasing trend with increase in IDRS score of the participants.
The present study showed that even in rural areas, nearly one-fourth of the adult population was at high risk, whereas more than half of the population was at moderate risk of developing diabetes mellitus. This corroborates the World Health Organization's (WHO's) stand to declare diabetes as a public health emergency and to devise ways to urgently mitigate this problem. Therefore, awareness and health education campaigns should be implemented in rural areas for early identification of risks, which will help in prevention and hence decreasing the burden of the disease.
糖尿病是当前非传染性疾病的主要杀手之一，给社会公共卫生带来了相当大的负担。印度糖尿病风险评分（IDRS）可作为一种风险评估工具，用于估计高危人群并规划适当的干预措施。本研究旨在通过使用IDRS评估旁遮普农村人口的糖尿病风险状况。
这是一项在获得机构伦理委员会批准后分两个阶段进行的横断面研究。第一阶段在波希尔的农村卫生培训中心（RHTC）进行，该中心门诊每第五位患者纳入研究。第二阶段在戈帕尔布尔村进行，该村是社区医学系现场实践区域的村庄之一，在获得参与者知情同意后逐户调查招募参与者。记录参与者的社会人口学特征、风险因素状况和IDRS。使用社会科学统计软件包（SPSS）26.0版对数据进行分析以计算百分比。定性变量采用Pearson卡方检验，定量变量采用均值、标准差和方差分析（ANOVA）。P值小于0.05被认为具有统计学意义。
来自RHTC的252名受试者（99名男性和153名女性）以及来自戈帕尔布尔村的213名受试者（71名男性和142名女性）参与了研究，他们的平均IDRS分别为44.8±15.7和46.6±21.1。计算RHTC招募的参与者的IDRS发现，15.5%为低风险，56%为中度风险，28.5%为高风险；而来自戈帕尔布尔村的参与者中，19.2%为低风险，57.3%为中度风险，23.5%为患糖尿病的高风险。发现女性、生活在大家庭中的受试者以及体重指数（BMI）高的受试者患糖尿病的风险更高。参与者的平均收缩压和舒张压随IDRS评分增加呈上升趋势。
本研究表明，即使在农村地区，近四分之一的成年人口处于高风险，而超过一半的人口处于患糖尿病的中度风险。这证实了世界卫生组织（WHO）将糖尿病宣布为公共卫生紧急情况并制定紧急缓解这一问题方法的立场。因此，应在农村地区开展提高认识和健康教育活动，以便早期识别风险，这将有助于预防并减轻疾病负担。
