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ORIGINAL ARTICLE
Year : 2022  |  Volume : 20  |  Issue : 4  |  Page : 240-244

Assessment of prevalence and risk factors of diabetes mellitus among the adult population in the campus of Hi-Tech Medical College and Hospital, Bhubaneswar


1 Department of Community Medicine, MKCG Medical College and Hospital, Berhampur, Odisha, India
2 Department of Community Medicine, Hitech Medical College and Hospital, Bhubaneswar, Odisha, India
3 Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India

Date of Submission31-May-2022
Date of Decision17-Jun-2022
Date of Acceptance20-Jun-2022
Date of Web Publication17-Oct-2022

Correspondence Address:
Dr. Prem Sagar Panda
Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cmi.cmi_65_22

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  Abstract 


Background: Diabetes mellitus, a lifestyle disease, is a 21st-century global health emergency, with a global prevalence projection of 537 million (10.5%) in 2021 and is the 7th largest cause of mortality. As a result, the study was carried out to analyze the prevalence of diabetes mellitus and its associated risk factors in the adult population. Materials and Methods: This 5-month institutional-based cross-sectional study on 410 randomly selected individuals was done on the campus of Hi-Tech Medical College and Hospital in Bhubaneswar among the adult population aged more than or equal to 18 years. Results: The prevalence of diabetes mellitus was determined to be 15.6% in the current study, with 58 (8.8%) individuals having impaired fasting glucose and 14.1% having impaired glucose tolerance. Diabetes mellitus prevalence increased gradually as people got older. Males had a higher prevalence (19.3%), which was statistically significant (P < 0.05). Diabetes was found to be statistically significant with the following risk factors: alcohol intake, consumption of sugar-sweetened beverages, body mass index, waist circumference, and blood pressure (P < 0.05). Conclusion: Diabetes mellitus is prevalent in the research area, and the current study has found the association of various modifiable risk factors with diabetes. Effective intervention methods, if implemented at this point, can help to reduce the disease's burden on the individual, family, and community.

Keywords: Diabetes mellitus, prevalence, risk factors


How to cite this article:
Samantara C, Mohanty SS, Panda PS, Nayak SR. Assessment of prevalence and risk factors of diabetes mellitus among the adult population in the campus of Hi-Tech Medical College and Hospital, Bhubaneswar. Curr Med Issues 2022;20:240-4

How to cite this URL:
Samantara C, Mohanty SS, Panda PS, Nayak SR. Assessment of prevalence and risk factors of diabetes mellitus among the adult population in the campus of Hi-Tech Medical College and Hospital, Bhubaneswar. Curr Med Issues [serial online] 2022 [cited 2022 Dec 1];20:240-4. Available from: https://www.cmijournal.org/text.asp?2022/20/4/240/358650




  Introduction Top


Diabetes mellitus has now become a global health emergency of catastrophic proportions. According to the International Diabetes Federation (2021), 1 in 11 adults (90 million) in Southeast Asia is diabetic, with India, known as the “DIABETES CAPITAL OF THE WORLD,” undergoing an epidemic of diabetes mellitus. It is projected that diabetes is estimated to affect 113 million adults by 2030 and 151 million by 2045.[1] According to the Indian council of medical research-India Diabetes (ICMR-INDIAB) (2008–2015) study conducted in 15 Indian states, the overall prevalence of diabetes mellitus was 7.3%, ranging from 10.6% to 11.2% in urban areas and 4.9%–5.4% in rural regions.[2] Diabetes is a disease of rich societies, despite being a more serious health problem in industrialized countries, because its prevalence has even increased faster in low- and middle-income countries than in high-income countries.[3] Aside from the genetic predisposition to diabetes mellitus, studies have revealed the impact of the interaction of host factors such as age, gender, family history, obesity, and environmental factors such as sedentary lifestyle, dietary pattern, socioeconomic status, and habits such as alcoholism and smoking.[2] The identification of these locally relevant and avoidable risk factors will aid in the early detection and prevention of diabetes mellitus. However, around 50% of persons with diabetes are undiagnosed. As a result, the 2022 Standards of Care indicate that screening for prediabetes and diabetes begins at the age of 35 years and is repeated every 3 years.[1] Diabetes can cause a series of vascular complications such as heart attack, stroke, kidney failure, leg amputation, eyesight loss, and nerve damage as well. Poorly controlled diabetes raises the risk of fetal mortality and other problems during pregnancy. According to the World Health Organization (WHO), noncommunicable diseases (NCDs) accounted for 71% of global fatalities in 2016, with diabetes ranking fourth and seventh among all causes of death. Diabetes mellitus was responsible for an estimated 1.5 million fatalities in 2019.[4],[5] Diabetes kills more than 80% of people in low- and middle-income nations.[2] Diabetes and its complications impose a significant economic burden on diabetics and their families, as well as national economies, through direct medical costs and loss of wages. Hence, it is very important to diagnose diabetes at the earliest and study has been undertaken to find out the prevalence and risk factors of diabetes mellitus among the adult population in the campus of Hi-Tech Medical College and Hospital, Bhubaneswar.


  Materials and Methods Top


Study design

The study design involves observational and community-based study.

Study area

Medical Campus area of Hi-Tech Medical College and Hospital, Bhubaneswar.

Study setting

Department of Community Medicine, Hi-tech Medical College and Hospital, Bhubaneswar.

Study duration

September 1st, 2015– December 31st, 2015.

Study populations

Residents staying on the campus of Hi-tech Medical College for more than 1-year and aged more than 18 years. These included undergraduate students, interns, postgraduate students, faculty members, doctors, nurses, paramedical staff, nonteaching staff, and family members of staff faculties staying in the staff quarters of the campus.

Inclusion criteria

Those who consent to take part in the study and resident on the campus for at least 1-year.

Exclusion criteria

(i) Persons not willing to participate in the study, (ii) pregnant women, (iii) lactating women up to 12 weeks postpartum, and (iv) seriously ill patients.

Sample size

The ICMR-INDIAB study (2008–2011) shows that the prevalence of diabetes in urban areas ranged from 10.9% to 14.2%, while in rural areas, the range was 3.0% to 8.3%.[6] The maximum prevalence rate of 14.2% was used for estimating the sample size for the present study taking 5% precision. The sample size came to be 185. With a design effect of 2 and adding a 10% nonresponse rate, the final sample size came to be 410.

Sampling method

Simple random sampling method was used. House-to-house survey was done till the desired sample size was obtained.

Data collection tool and methods: Interview method

The purpose of the study was explained thoroughly and recruitment as study subjects was done after a voluntary written informed consent. The study participants were then interviewed through the pretested and preformed questionnaire which included their sociodemographic profile, socioeconomic status, risk factors associated, and health-seeking behavior was collected. Measurement of height, weight, waist and hip circumference, body mass index (BMI), pulse, and blood pressure was done. Fasting blood sugar and 2 h postprandial blood sugar estimations were done.

Ethical permission

Approval of the Institutional Ethics Committee was taken [Letter no. HMCH/IEC/PG/15/1881(2)DATE 03/08/2015.

Statistical analysis

Data collected were entered in a Microsoft Excel sheet and then analyzed by SPSS (Statistical Package for the Social Sciences ) Version 20.0 developed by IBM India and accessed in Kalinga Institute of Medical Sciences, Bhubaneswar. Descriptive analysis was done using proportion, mean, and standard deviation. A Chi-square test was applied to find out the association of diabetes mellitus with different risk factors and a P < 0.05 was considered statistically significant.


  Results Top


There were 410 study volunteers, 238 (58.0%) males, and 172 (42.0%) females. The majority, 195 (47.6%), were between the ages of 20 and 30 years and 391 (95.4%) were Hindus. 309 (73.5%) studied up to intermediate, postgraduate, or graduate level. 137 (33.4%) were professionals, and 324 (70.0%) were from the high and upper-middle socioeconomic sectors. The majority of 217 (52.9%) were sedentary, while 218 (53.2%) were either overweight or obese [Table 1]. Diabetes prevalence was determined to be 64 (15.6%) in the current study, 8.8% in impaired fasting glucose, and 14.1% in impaired glucose tolerance. Diabetes was diagnosed in 19.3% of males and 10.5% of females and prevalence was greatest in the age group 40–50 years, i.e., 52.5%. It showed that diabetes mellitus increased considerably with increasing age. Out of 64 diabetics identified, 16 (39.0%) had a positive family history of diabetes mellitus, 58 (90.6%) were either overweight or obese, 36 (56.2%) belonged to the upper class, and 45 (70.0%) had a sedentary lifestyle. In this study, it was discovered that 77.3% of the whole study group exercised regularly. Paradoxically, regular physical activity was observed in larger proportions in diabetics, suggesting that diabetics may have begun physical exercise as part of medical recommendations after being diagnosed. 29 (40.2%) of diabetics smoked, 9 (27.2%) drank alcohol, 37 (57.8%) drank sugar-sweetened beverages more than once/day, and 62 (96.8%) ate meat. It was shown that 84.7% of male diabetics had a waist-to-hip ratio (WHR) of more than 0.90 and 38.9% of female diabetics had a WHR >0.85 [Table 2].
Table 1: Sociodemographic profile of study population

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Table 2: Assessment of risk factors of diabetes mellitus

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  Discussion Top


Males were 238 (58.0%) and females were 172 (42.0%) in the current cross-sectional survey. Males were 48.2% and females were 51.8% in the research by Govindu et al.[7] The bulk of the study participants, 195 (47.6%), were between the ages of 20 and 30, with the fewest being over 60 (6.1%). In the ICMR-INDIAB research, however, the age group 40–49 years represented a maximum of 31.9%.[6] This might be because the bulk of the research participants were medical students, interns, or postgraduates at a medical institution. Although 48.3% of the research group was single, Rahmanian et al. established in their study that the majority were married (90.8%).[8] This might be because the bulk of the study population was between the ages of 20 and 30 and were students, hence the unmarried population group was higher in the current study.

According to the findings of this survey, all were literate, and the vast majority were either graduates, postgraduates, or professionals. There were no illiterates discovered. In contrast, the literacy rate was 70.9% in the study by Muninarayana et al.[9]

According to the current study, 34.6% of the study respondents were from the high socioeconomic class, and 44.4% were from the upper-middle class. According to research was done by Siddhartha et al., the proportion of diabetes was 13% in the lower class, 22% in the middle class, and 60% in the upper class.[10]

Diabetes prevalence was 15.6% in the current research, with males having 19.3% and females having 10.5%. The survey findings of the national noncommunicable disease monitoring survey (NNMS) 2017–2018 showed the prevalence of raised blood sugar as 9.3%. In our study, it may be higher due to the presence of other risk factors.[11] Similarly, Thankappan et al. found that the prevalence of diabetes was 14.8% in their study, while Rao et al. found that the prevalence of diabetes was 18.8% in males and 14.4% in females.[12],[13] Males suffered more than females in both experiments, which might be attributed to their unhealthy lifestyles.

Diabetes prevalence was highest in the age range 40–50 years, i.e., 52.5%, in the current research, and diabetes mellitus increased considerably with increasing age. This is also consistent with the findings of a research done by Siddhartha et al., who discovered a rise in the proportion of diabetes as age advanced, i.e., 35–44 years (13%), 45–44 years (32%), 55–64 years (38%), and >65 years (11.7%).[10]

In the current investigation, 3.9% of the entire study population had a positive family history of diabetes. According to Zafar et al., 4.4% of the entire population had a positive family history.[14] According to Rao et al., 26% of diabetics have a family history of diabetes.[13] According to the research findings, genetic characteristics are one of the major risk factors.

Diabetes was shown to be extremely substantially related to rising BMI in the current study. It was shown that 58 (90.6%) of diabetics had a BMI of 25 kg/m2. In research was done by Malini et al., 13.6% had a BMI of 21–25 kg/m2 and the rest were beyond the upper limit (obese or overweight).[15]

There was a strong association found between higher socioeconomic class and diabetes prevalence. Other investigations, such as the one by Rao et al., found that 32% of diabetics belonged to the upper class, and the research by Siddhartha et al. found a similar outcome to ours.[10],[13] The higher prevalence in the higher socioeconomic category might be attributed to their increased consumption of junk food and sedentary lifestyle.

It was shown that 77.3% of the overall study population frequently has physical activity. Diabetes was discovered to be highly related to physical activity. According to the world health survey (WHS) dissemination workshop report, 71% of the participants did physical activity regularly.[16] According to Mehta et al., 46.4% of diabetics have sedentary lifestyles.[17] According to the NNMS (2017–2018), only 58.7% of participants were physically active, which is low compared to our study.[11] Paradoxically, it was shown that diabetics had greater proportions of regular physical activity, indicating that diabetics may have begun physical exercise as part of medical recommendations after being diagnosed.

Diabetes was shown to be substantially more prevalent among people who smoked and drank alcohol. Similar to the current study, a study from Moradabad found a substantial relationship between diabetes and alcohol consumption.[18] In Manipur's study, diabetics had a greater rate of tobacco usage (31.6%) than nondiabetics (29.4%).[19]

There was a substantial association between nonvegetarian diet and diabetes in this study. Similarly, research from Moradabad indicated a greater prevalence of diabetes among individuals who ate a nonvegetarian diet and consumed a lot of saturated fat. This might be owing to the high fat and protein levels of nonvegetarian foods.[18] In this study, there was a substantial link between sugar-sweetened beverage (SSB) intake of more than one drink per day and diabetes. In comparison, research by Schulze et al. revealed the same conclusion as the current study that the prevalence of diabetes was greater among SSB consumers.[18]


  Conclusion Top


It is possible to conclude that the prevalence of diabetes is high in this research location. The prevalence in our study is high compared to the national level surveys such as WHO-INDIAB, NNMS, and National NCD survey. The study's findings suggest that modifiable risk factors such as obesity, sedentary lifestyle, alcohol use, cigarette smoking, and SSB usage >1 drink/day are strongly linked with diabetes. Hence, health promotion measures along with the strategic change in the NCD survey will be factored in reducing the disease burden. As most of the study participants belonged to high socioeconomic status and educational status, so minimum health promotional measures will have a great impact on the study population. Although age is a nonmodifiable risk factor, diabetes mellitus may be avoided by leading a healthy lifestyle, exercising regularly, and keeping a healthy body weight.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
IDF Diabetes Atlas – Home; 2017. Available from: https://www.diabetesatlas.org/. [Last accessed on 2022 Mar 02].  Back to cited text no. 1
    
2.
Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: Results from the ICMR-INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol 2017;5:585-96.  Back to cited text no. 2
    
3.
Mohan V, Deepa M, Deepa R, Shanthirani CS, Farooq S, Ganesan A, et al. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India – The Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia 2006;49:1175-8.  Back to cited text no. 3
    
4.
WHO Mortality Database – WHO. Available from: https://www.who.int.https://www.who.int/data/data-collection-tools/who-mortality-database. [Last accessed on 2022 Mar 02].  Back to cited text no. 4
    
5.
American Diabetes Association Professional Practice Committee. 1. Improving care and promoting health in populations: Standards of medical care in diabetes-2022. Diabetes Care 2022;45:S8-16.  Back to cited text no. 5
    
6.
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;54:3022-7.  Back to cited text no. 6
    
7.
Govindu S, Krishna BG, Prabhu GR. Prevalence Of Diabetes Mellitus Among Adults In Tirupati and Its Association With Certain Socio - Demographic Factors. Journal of Evolution of Medical and Dental Sciences 2015;4:4822-8. doi:10.14260/jemds/2015/699.  Back to cited text no. 7
    
8.
Rahmanian K, Shojaei M, Sotoodeh Jahromi A. Relation of type 2 diabetes mellitus with gender, education, and marital status in an Iranian urban population. Rep Biochem Mol Biol 2013;1:64-8.  Back to cited text no. 8
    
9.
Muninarayana C, Balachandra G, Hiremath SG, Iyengar K, Anil NS. Prevalence and awareness regarding diabetes mellitus in rural Tamaka, Kolar. Int J Diabetes Dev Ctries 2010;30:18-21.  Back to cited text no. 9
    
10.
Siddartha S, Rao PM, Kumari S, Kumar S, LN M. An epidemiology of prevalence of Type 2 Diabetes among the adult residents in Dakshina Kannada district. Research Journal of Pharmaceutical, Biological and Chemical Sciences 2010;1:586-92.  Back to cited text no. 10
    
11.
Mathur P, Kulothungan V, Leburu S, Krishnan A, Chaturvedi HK, Salve HR, et al. National noncommunicable disease monitoring survey (NNMS) in India: Estimating risk factor prevalence in adult population. PLoS One 2021;16:e0246712.  Back to cited text no. 11
    
12.
Thankappan KR, Shah B, Mathur P, Sarma PS, Srinivas G, Mini GK, et al. Risk factor profile for chronic non-communicable diseases: results of a community-based study in Kerala, India. Indian J Med Res 2010;131:53-63.  Back to cited text no. 12
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13.
Rao CR, Kamath VG, Shetty A, Kamath A. A study on the prevalence of type 2 diabetes in coastal Karnataka. Int J Diabetes Dev Ctries 2010;30:80-5.  Back to cited text no. 13
    
14.
Zafar J, Bhatti F, Akhtar N, Rasheed U, Bashir R, Humayun S, et al. Prevalence and risk factors for diabetes mellitus in a selected urban population of a city in Punjab. J Pak Med Assoc 2011;61:40-7.  Back to cited text no. 14
    
15.
Malini DS, Sahu A, Mohapatro S. Assessment of risk factors for development of type-II Diabetes Mellitus among working women in Berhampur, Orissa. Indian Journal of Community Medicine 2009;34:232-6.  Back to cited text no. 15
    
16.
WHO. Technical Report – World Health Survey Dissemination Workshop. India: WHO; 2003.  Back to cited text no. 16
    
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Mehta RS, Karki P, Sharma SK. Risk factors, associated health problems, reasons for admission and knowledge profile of diabetes patients admitted in BPKIHS. Kathmandu Univ Med J (KUMJ) 2006;4:11-3.  Back to cited text no. 17
    
18.
Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 2004;292:927-34.  Back to cited text no. 18
    
19.
Shah A, Afzal M. Prevalence of diabetes and hypertension and association with various risk factors among different Muslim populations of Manipur, India. J Diabetes Metab Disord 2013;12:52.  Back to cited text no. 19
    



 
 
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