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Characteristics of undiagnosed diabetes in men and women under the age of 50 years in the Indian subcontinent: the National Family Health Survey (NFHS-4)/Demographic Health Survey 2015-2016.
- Source :
-
BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2020 Feb; Vol. 8 (1). - Publication Year :
- 2020
-
Abstract
- Objective: Prior studies examining diabetes prevalence in India have found that nearly 50% of the diabetes population remains undiagnosed; however, the specific populations at risk are unclear.<br />Research Design and Methods: First, we estimated the prevalence of undiagnosed diabetes in India for 750 924 persons between the ages of 15 years and 50 years who participated in the National Family Health Survey (NFHS-4)/Demographic Health Survey (2015-2016), a cross-sectional survey of all 29 states and 7 union territories of India. We defined 'undiagnosed diabetes' as individuals who did not know about their diabetes status but had high random (≥200 mg/dL) or fasting (≥126 mg/dL) blood glucose levels. Second, using Poisson regression, we associated 10 different factors, including the role of healthcare access, and undiagnosed diabetes. Third, we examined the association of undiagnosed diabetes with other potential comorbid conditions.<br />Results: The crude prevalence of diabetes for women and men aged 15-50 years was 2.9%, 95% CI 2.9% to 3.1%, with self-reported diabetes prevalence at 1.7%, 95% CI 1.6 to 1.8. The overall prevalence of undiagnosed diabetes for 15-50 year olds was at 1.2%, 95% CI 1.2% to 1.3%. Forty-two per cent, 95% CI 40.7% to 43.4% of the individuals with high glucose levels were unaware of their diabetes status. Approximately 45%, 95% CI 42.9% to 46.4% of undiagnosed diabetes population had access to healthcare. Men, younger individuals, and those with lower levels of education were most at risk of being undiagnosed. Geographically, the Southern states in India had a significantly higher prevalence of undiagnosed diabetes despite having nearly universal access to healthcare. Risk factors combined with random glucose could predict undiagnosed diabetes (area under the curve of 97.8%, 95% CI 97.7% to 97.8%), Nagelkerke R <superscript>2</superscript> of 66%).<br />Conclusion: Close to half (42%) of the people with diabetes in India are not aware of their disease status, and a large subset of these people are at risk of poor detection, despite having health insurance and/or having access to healthcare. Younger age groups and men are the most vulnerable.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)
- Subjects :
- Adolescent
Adult
Age Factors
Blood Glucose analysis
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus blood
Fasting blood
Female
Health Surveys
Humans
India epidemiology
Male
Middle Aged
Prevalence
Risk Factors
Self Report
Sex Factors
Undiagnosed Diseases blood
Young Adult
Diabetes Mellitus diagnosis
Diabetes Mellitus epidemiology
Undiagnosed Diseases diagnosis
Undiagnosed Diseases epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2052-4897
- Volume :
- 8
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMJ open diabetes research & care
- Publication Type :
- Academic Journal
- Accession number :
- 32098896
- Full Text :
- https://doi.org/10.1136/bmjdrc-2019-000965