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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

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. RESEARCH DESIGN AND METHODS: First, we estimated the prevalence of undiagnosed diabetes in India for 750 9...

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Autores principales: Claypool, Kajal T, Chung, Ming-Kei, Deonarine, Andrew, Gregg, Edward W, Patel, Chirag J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206915/
https://www.ncbi.nlm.nih.gov/pubmed/32098896
http://dx.doi.org/10.1136/bmjdrc-2019-000965
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author Claypool, Kajal T
Chung, Ming-Kei
Deonarine, Andrew
Gregg, Edward W
Patel, Chirag J
author_facet Claypool, Kajal T
Chung, Ming-Kei
Deonarine, Andrew
Gregg, Edward W
Patel, Chirag J
author_sort Claypool, Kajal T
collection PubMed
description 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. 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. 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(2) of 66%). 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.
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spelling pubmed-72069152020-05-12 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 Claypool, Kajal T Chung, Ming-Kei Deonarine, Andrew Gregg, Edward W Patel, Chirag J BMJ Open Diabetes Res Care Cardiovascular and Metabolic Risk 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. 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. 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(2) of 66%). 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. BMJ Publishing Group 2020-02-24 /pmc/articles/PMC7206915/ /pubmed/32098896 http://dx.doi.org/10.1136/bmjdrc-2019-000965 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Cardiovascular and Metabolic Risk
Claypool, Kajal T
Chung, Ming-Kei
Deonarine, Andrew
Gregg, Edward W
Patel, Chirag J
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Cardiovascular and Metabolic Risk
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206915/
https://www.ncbi.nlm.nih.gov/pubmed/32098896
http://dx.doi.org/10.1136/bmjdrc-2019-000965
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