Indian diabetic risk score as a screening tool for assessment of diabetes in urban and rural areas in Andhra Pradesh

Authors

  • P. K. S. S. Usha Sri Department of Community Medicine, Government Medical College affiliated Dr. Y.S.R University of Health Sciences, Ongole, Andhra Pradesh, India
  • B. T. Rao Department of Community Medicine, Government Medical College affiliated Dr. Y.S.R University of Health Sciences, Ongole, Andhra Pradesh, India
  • S. Appala Naidu Department of Community Medicine, Government Medical College affiliated Dr. Y.S.R University of Health Sciences, Ongole, Andhra Pradesh, India
  • K. Mokshanand Department of Community Medicine, Government Medical College affiliated Dr. Y.S.R University of Health Sciences, Ongole, Andhra Pradesh, India
  • N. Naga Lakshmi Department of Community Medicine, Government Medical College affiliated Dr. Y.S.R University of Health Sciences, Ongole, Andhra Pradesh, India
  • M. Divya Keerthi Department of Community Medicine, Government Medical College affiliated Dr. Y.S.R University of Health Sciences, Ongole, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20222993

Keywords:

Diabetes mellitus, IDRS, Perceived stress scale, Physical activity, BMI

Abstract

Background: Diabetes mellitus is a major public health problem in Andhra Pradesh and Indian diabetes risk score (IDRS) is a cost-effective tool for screening of undiagnosed diabetic individuals in the community. The objectives of this study were to assess the sensitivity and specificity of IDRS method as a screening tool in community as well as to determine the importance of stress scale in relation with diabetes.  

Methods: This cross-sectional study was conducted from April 2022 to May 2022 among 18 years and above residing in select areas of Prakasam and Visakhapatnam districts. House to house survey was done for collecting data on IDRS with pretested questionnaire. Cohen's perceived stress scale was used to assess the level of stress.  

Results: Out of 200 study subjects, 53.5% were males, mean age was 40.13±15 years and 23% were illiterate. The overall prevalence of diabetes was 21.0%, as per IRDS, 20.5% were in low-risk category. 44.5% and 31.5% were in moderate and high-risk category respectively. No physical exercise- 45 (71.7%), consumption of non-vegetarian food- 43 (65%), low consumption of fruits- 47 (74.6%) among high-risk category. Sensitivity of IDRS was 50.6%, specificity 71.6%, positive predictive value 33.8% and negative predictive value 86.3%. Mean perceived stress score was found to be 19.5±4.03.

Conclusions: This study estimated the usefulness of Indian diabetes risk score for identifying high risk diabetic subjects in Indian urban population so that proper intervention can be done to reduce the burden of disease. Stress may be included in the IDRS.

References

Mendis S, Davis S, Norrving B. Organizational update: the world health organization global status report on noncommunicable diseases 2014; one more landmark step in the combat against stroke and vascular disease. Stroke. 2015;46(5):e121-2.

IDF. International Diabetes Federation Diabetes Atlas. 8th ed. Belgium: IDF; 2017: 106.

Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research-INdia DIABetes (ICMR-INDIAB) study. Diabetologia. 2011;54(12):3022-7.

World Economic Forum. The Global Economic Burden of Non-communicable Diseases. Geneva, Switzerland: World Economic Forum; 2011: 45.

Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003;26(3):725-31.

Mohan V, Vassy JL, Pradeepa R, Deepa M, Subashini S. The Indian type 2 diabetes risk score also helps identify those at risk of macrovasvular disease and neuropathy (CURES-77). J Assoc Physicians India. 2010;58:430-3.

Sharma KM, Ranjani H, Nguyen H, Shetty S, Datta M, Narayan KM, et al. Indian Diabetes Risk Score helps to distinguish type 2 from non-type 2 diabetes mellitus (GDRC-3). J Diabetes Sci Technol. 2011;5(2):419-25.

Lindström J, Peltonen M, Eriksson JG, Aunola S, Hämäläinen H, Ilanne-Parikka P, et al. Determinants for the effectiveness of lifestyle intervention in the Finnish Diabetes Prevention Study. Diabetes Care. 2008;31(5):857-62.

Lee CM, Colagiuri S. Risk scores for diabetes prediction: the International Diabetes Federation PREDICT-2 project. Diabetes Res Clin Pract. 2013;100(2):285-6.

Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005;53:759-63.

Ramachandran A, Snehalatha C, Vijay V, Wareham NJ, Colagiuri S. Derivation and validation of diabetes risk score for urban Asian Indians. Diabetes Res Clin Pract. 2005;70(1):63-70.

Schwarz PE, Li J, Lindstrom J, Tuomilehto J. Tools for predicting the risk of type 2 diabetes in daily practice. Horm Metab Res. 2009;41(2):86-97.

Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103(2):137-49.

Pradeepa R, Rema M, Vignesh J, Deepa M, Deepa R, Mohan V. Prevalence and risk factors for diabetic neuropathy in an urban south Indian population: the Chennai Urban Rural Epidemiology Study (CURES-55). Diabet Med. 2008;25(4):407-12.

International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey(NFHS-4), 2015-2016: India, Mumbai IIPS: 399-403. Available at: https://dhsprogram.com/pubs/pdf/FR339/ FR339.pdf. Accessed on 3 June 2022.

Selye H. Stress without Distress. New York: J. B. Lippencott; 1974.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385-96.

Ranasinghe P, Jayawardena R, Gamage N, Sivanandam N, Misra A. Prevalence and trends of the diabetes epidemic in urban and rural India: A pooled systematic review and meta-analysis of 1.7 million adults. Ann Epidemiol. 2021;58:128-48.

Cohen S, Williamson G. Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S, eds. The social psychology of health: ClaremontSymposium on applied social psychology. Newbury Park, CA: Sage; 1988.

Acharya AS, Singh A, Dhiman B. Assessment of Diabetes Risk in an Adult Population Using Indian Diabetes Risk Score in an Urban Resettlement Colony of Delhi. J Assoc Physicians India. 2017;65(3):46-51.

Sankar P, Sasikumar P, Medayil R, Jacob R, Sasidharan S. Diabetes risk in women employees (DRIWE)- An institution‑based screening model detects high prevalenceof women employees at risk of type 2 diabetes. American Diabetes Association. 2018;67.

Indian Council of Medical Research. Assessment of Burden of Non-Communicable diseases, 2004. Available at: Available at www. whoindia. org/LinkFiles/Assessment_of_Burden_of_NCD_Hypertension_Assessment_of_Burden_of_NCDs.. Accessed on 02 September 2022.

Arun A, Srivastava JP, Gupta P, Sachan B, Daya P, Zaidi ZH. Indian diabetes risk score (IDRS), a strong predictor of diabetes mellitus : A cross sectional study among urban and rural population of Lucknow. Int J Appl Res. 2015;1:135-8.

Panda PS, Jain K, Soni GP, Gupta SA, Chandrakar A, Pradhan SK. Screening for risk of diabetes among adult population of Raipur city using Indian diabetic risk score. Int J Med Sci Public Health. 2017;6:1038-41.

Khandhedia SA, Chaudhary AI, Unadkat S, Parmar D. A study on assessment of risk of developing diabetes using IDRS (Indian diabetes risk score) in the urban area of Jamnagar city. Sch J Appl Med Sci. 2015;3:2358-60.

Brahmbhatt KR, Chakraborty T, Gopal C, Shwethashree M, Madappady S, Sowndarya TA, et al. Assessment of risk of Type 2 diabetes using simplified Indian diabetes risk score community-based cross-sectional study. Int J Med Sci Public Health. 2016;5:2522-5.

Mani G, Annadurai K, Danasekaran R. Application of Indian diabetic risk score in screening of an undiagnosed rural population of Kancheepuram district, Tamil Nadu a cross sectional survey. MRIMS J Health Sci. 2014;2:81-3.

Gupta SK, Singh Z, Purty AJ, Vishwanathan M. Diabetes prevalence and its risk factors in urban Pondicherry. Int J Diabetes Dev Ctries. 2009;29(4):166-9.

Shobha MV, Deepali A. Indian diabetic risk score (IDRS): A novel tool to assess the risk of Type 2 diabetes mellitus. Indian J Basic Appl Med Res. 2016;5:106-10.

Nagalingam S, Sundaramoorthy K, Arumugam B. Screening for diabetes using Indian diabetes risk score. Int J Adv Med. 2016;3:415-8.

Khan MM, Sonkar GK, Alam R, Mehrotra S, Khan MS, Kumar A, et al. Validity of Indian Diabetes Risk Score and its association with body mass index and glycosylated hemoglobin for screening of diabetes in and around areas of Lucknow. J Family Med Prim Care. 2017;6(2):366-73.

Singh MM, Mangla V, Pangtey R, Garg S. Risk Assessment of Diabetes Using the Indian Diabetes Risk Score: A Study on Young Medical Students from Northern India. Indian J Endocrinol Metab. 2019;23(1):86-90.

Turale AD, Khandekar V, Patrikar VG. Indian Diabetes Risk Score For Screening Of Undiagnosed Pre- Diabetic Individuals Of Sakkardara Region Of Nagpur City. Int Ayur Med J. 2017;5(10):3722-5.

Brinda P, Santosh A. A study to determine the hidden part of the iceberg of diabetes, using Indian diabetes risk score as ascreening tool in rural population of Bangalore, Karnataka, India. IntJ Community Med. 2016;3:3076-80.

Dugg P, Cherian V, Upadhyay MK. Opportunistic screening for diabetes using Indian diabetes risk scoreamong patients aged 30 years and above attending rural health training center in Delhi. Int J Med Sci Public Health. 2019;8(4):264-9.

Arora V, Singh MJ, Khanna P, Goyal N, Kumar N, Singh M. Prevalence of diabetes in urban Haryana. Australas Med J. 2010;3(8):488-94.

Patil RS, Gothankar JS. Assessment of risk of type 2 diabetes using the Indian Diabetes Risk Score in an urban slum of Pune, Maharashtra, India: a cross-sectional study. WHO South East Asia J Public Health. 2016;5(1):53-61.

Chaturvedi M, Pandey A, Javed M, Baiswar R. Validity of Indian Diabetes Risk Score (IDRS) in Population in and Around Agra. J Assoc Physicians India. 2018;66(10):33-5.

Adhikari P, Pathak R, Kotian S. Validation of the MDRF-Indian Diabetes Risk Score (IDRS) in another south Indian population through the Boloor Diabetes Study (BDS). J Assoc Physicians India. 2010;58:434-6.

Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India. 2005;53:759-63.

Dudeja P, Singh G, Gadekar T, Mukherji S. Performance of Indian Diabetes Risk Score (IDRS) as screening tool for diabetes in an urban slum. Med J Armed Forces India. 2017;73(2):123-8.

Sulaiman N, Mahmoud I, Hussein A, Elbadawi S, Abusnana S, Zimmet P, et al. Diabetes risk score in the United Arab Emirates: a screening tool for the early detection of type 2 diabetes mellitus. BMJ Open Diabetes Res Care. 2018;6(1):e000489.

Tsigos C, Chrousos GP. Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res. 2002;53(4):865-71.

Rod NH, Grønbaek M, Schnohr P, Prescott E, Kristensen TS. Perceived stress as a risk factor for changes in health behaviour and cardiac risk profile: a longitudinal study. J Intern Med. 2009;266(5):467-75.

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Published

2022-11-28

How to Cite

Sri, P. K. S. S. U., Rao, B. T., Naidu, S. A., Mokshanand, K., Lakshmi, N. N., & Keerthi, M. D. (2022). Indian diabetic risk score as a screening tool for assessment of diabetes in urban and rural areas in Andhra Pradesh. International Journal Of Community Medicine And Public Health, 9(12), 4417–4424. https://doi.org/10.18203/2394-6040.ijcmph20222993

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Original Research Articles