Basu Saurav, Maheshwari Vansh, Malik Mansi, Agarwal Paras
Indian Institute of Public Health - Delhi, Public Health Foundation of India, Plot No 47, Institutional Area, Sector 44, Gurugram, 122002 Haryana India.
Max Healthcare, Max Multi Speciality Centre, Panchsheel Park, New Delhi India.
J Diabetes Metab Disord. 2023 Jul 24;22(2):1405-1415. doi: 10.1007/s40200-023-01263-9. eCollection 2023 Dec.
Weak care cascade of diabetes from the time of screening, diagnosis, treatment initiation and attainment of optimal glycemic control is a public health challenge particularly in resource limited settings. We aimed to assess the diabetes care cascade in India and its determinants in the 15-49 age group.
We conducted a secondary data analysis of the National Family Health Survey (NFHS-5, 2019-2021), a nationally representative cross-sectional survey, including a total of 724,115 women and 101,839 men with mean (SD) age 30.6 (9.9) years.
The prevalence of self-reported Diabetes Mellitus (DM) in the sample was 2.14% (n = 14,116, 95% CI: 2.06, 2.21) of which 55.13% (n = 6990, 95% CI: 53.37, 56.88) were currently undergoing anti-diabetes therapy. The net prevalence of DM including both old and new cases detected on screening was 2.9%. Poor glycemic control was observed in 52.43% (n = 3506, 95% CI: 50.69, 54.16) of patients with DM on anti-diabetes therapy. Patients from the richest wealth quintile (aOR = 5.17, 95% CI: 1.93, 13.84) had significantly higher odds of accessing private health facilities, while female patients with DM were less likely to be on anti-diabetes therapy.
The prevalence of self-reported DM in India has increased from 1.7% (NFHS-4, 2015-16) to 2.1% (NFHS-5, 2019-21) while more than half of existing patients continue to remain undiagnosed. Consequently, diabetes care cascade have major lacunae at every stage from screening to diagnosis, initiation of effective treatment, and achievement of safe blood glucose levels.
The online version contains supplementary material available at 10.1007/s40200-023-01263-9.
从筛查、诊断、开始治疗到实现最佳血糖控制，糖尿病的护理环节薄弱是一项公共卫生挑战，在资源有限的环境中尤为如此。我们旨在评估印度15 - 49岁年龄组的糖尿病护理环节及其决定因素。
我们对全国家庭健康调查（NFHS - 5，2019 - 2021）进行了二次数据分析，这是一项具有全国代表性的横断面调查，共纳入724,115名女性和101,839名男性，平均（标准差）年龄为30.6（9.9）岁。
样本中自我报告的糖尿病（DM）患病率为2.14%（n = 14,116，95%置信区间：2.06，2.21），其中55.13%（n = 6990，95%置信区间：53.37，56.88）目前正在接受抗糖尿病治疗。筛查时检测出的新老糖尿病病例的净患病率为2.9%。在接受抗糖尿病治疗的糖尿病患者中，52.43%（n = 3506，95%置信区间：50.69，54.16）的患者血糖控制不佳。最富有的五分之一人群中的患者（调整后比值比 = 5.17，95%置信区间：1.93，13.84）使用私立医疗机构的几率显著更高，而患有糖尿病的女性患者接受抗糖尿病治疗的可能性较小。
印度自我报告的糖尿病患病率已从1.7%（NFHS - 4，2015 - 16）升至2.1%（NFHS - 5，2019 - 21），而超过一半的现有患者仍未被诊断出来。因此，糖尿病护理环节在从筛查到诊断、开始有效治疗以及实现安全血糖水平的每个阶段都存在重大缺陷。
在线版本包含可在10.1007/s40200 - 023 - 01263 - 9获取的补充材料。
