PREVELANCE STUDY OF DIABETES IN VILLAGE
POPULATION – SUCHINDRUM, KANYAKUMARI DISTRICT
Project work submitted as a part of PG Diploma in Health Sciences in Public Health
BY
M.THANKASIVAM
(Enrl.No.5511000022)
Under the guidance of
Dr.N.ETHIRAJAN
Dr.T.M.JAYASREE
Dr.A.J.W.FELIX
Dr.PRIYADHARSINI
Dr.KALYANI
DIVISION OF COMMUNITY MEDICINE
RAJAH MUTHIAH MEDICAL COLLEGE
ANNAMALAI UNIVERSITY
Annamalai Nagar
April 2011
INTRODUCTION
Diabetes:
The word diabetes is from the Greek diabanein which means to pass through, in reference to the excessive urine produced as a symptom of these diseases. The term diabetes, without qualification, usually refers to diabetes mellitus, which roughly translates to excessive sweet urine. Several rare conditions are also named diabetes. The most common of these is diabetes insipidus in which large amounts of urine are produced, which is not sweet (insipidus meaning "without taste" in Latin).
The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM). Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes mellitus (NIDDM). Beyond these two types, there is no agreed-upon standard nomenclature. Various sources have defined "type 3 diabetes" as: gestational diabetes insulin-resistant type 1 diabetes (or "double diabetes"), type 2 diabetes which has progressed to require injected insulin, and latent autoimmune diabetes of adults (or LADA or "type1.5" diabetes).
OBJECTIVES
¿ To find out the prevalence of Diabetes in village population in Suchindrum
¿ spread awareness regarding risk factors like obesity, age, sex, heredity work conditions,
¿ detect early asymptomatic and undiagnosed cases especially those at high risk.
REVIEW OF LITERATURE
Great efforts have been made by developed countries to control infectious diseases, but non-communicable diseases have not received much attention. Diabetes mellitus is one of the non-communicable diseases which have become a major global health problem. The International Diabetes Federation (IDF) estimated that there are 100 million people with diabetes worldwide that is about 6% of all adults. This figure is expected to reach around 240 million by 2010. In Asia, prevalence of diabetes is high and it has been estimated that 20% of the current global diabetic population resides in South- East Asia. Indeed, the number of cases in India is likely to double in two decades that is from 39.9 million (in 2007) to 69.9 million by 2025. The study done by Indian Council of Medical Research (ICMR) in the year 1970 reported a prevalence of 2.3% in urban areas, which had increased to 12-19% in the year 2000. Correspondingly, in rural areas, prevalence rates had increased from 1% to 4-10%, and in the other study it was reported to be 13.2%. Thus, it is clear that both in urban and rural India, prevalence rates of diabetes are increasing rapidly with estimation of 2:1 to 3:1. These prevalence rates are being maintained from the last 2-3 decades but in Kerala where rural prevalence rates are caught up or overtaken urban prevalence rates.
The different types of diabetes presents as
Type 1 diabetes: This type of diabetes is associated with the destruction of insulin producing beta cells in the pancreas. This diabetes will require insulin for survival; this diabetes usually affects children and young adults. The presentation is acute and is often mistaken for an acute infective illness in children. This should be suspected when a child or young adult presents with fever, pain abdomen, polyuria and weight loss usually following a shore febrile illness.
Type 2 diabetes: This is the common form of diabetes which is seen in adults. The symptomatic patients will present with polyuria, polydipsia and weight loss. Three may be an increase in infections such as skin infection, pruritus vulvae in women. Alternatively the asymptomatic patients are diagnosed to have diabetes when they present with high plasma glucose when the blood test is done for some other illness or screening. Other less common types of diabetes are due to pancreatic disorders and fibrocalculous type of diabetes seen more commonly in southern states. Gestational diabetes: Diabetes detected with hyperglycemia during pregnancy.
EPIDEMILOGY OF THE CONDITION OUR COUNTRY
India has the largest number of diabetes in the world. India also has the dubious distinction of being termed the diabetes capital of the world. The data published by the international diabetes federation in the year 2006 the number of people with type 2 diabetes in India is around 40.9 million and this expected to rise to 69.9 million by 2025. The more disturbing trend is the shift age of onset of diabetes
Diabetes is defined as a metabolic disorder characterized by presence of hyperglycemia due to defective insulin secretion, insulin action or both. The chronic hyperglycemia is associated with significant long term sequels, particularly damage or dysfunction of various organs especially the kidneys, eyes, nerves, heart and blood vessels.
The present classification of diabetes is based on the etiology of diabetes. The classification of diabetes is
1. Type 1 diabetes mellitus (beta – cell destruction, usually leading to absolute insulin deficiency )
2. Type 2 diabetes mellitus (may range from predominantly insulin resistance with relative insulin deficiency to predominantly secretory defect with insulin resistance)
3. Gestational diabetes mellitus (onset or recognition of glucose intolerance in pregnancy)
4. other specific types
¿ Genetic defects of beta – cell function ( maturity onset diabetes of young)
¿ Genetic defects in insulin action.
¿ Type A insulin resistance, Leprechaunisim, RabsonMendenhall syndrome.
¿ Diseases of the endocrine pancreas
¿ Pancreatitis, Trauma, Pancreatectomy, Cystic, Fibrosis, Hemochromatosis, Fibrocalculous pancreatopathy
¿ Endocrinopathies
¿ Acromegaly, Cushing’s syndrome, Pheochhromocytoma, and Hyperthyroidism.
¿ Drug or chemical induced for e.g Pentamidine, Nicotinic acid, Glucocorticoids, Diazoxide, Beta – adrenegic agonists and Thiazide diuretics.
Diabetes risk factors
Diabetes has several risk factors that present interactive, addictive, and synergistic effects. Thus, upon preventing one risk factor, it is possible to help prevent Diabetes.
In individuals
¿ Background risk factors, such as age, sex, level of education, and genetic composition;
¿ Behavioral risk factors, such as smoking, unhealthy diet, and physical inactivity; and
¿ Intermediate risk factors, such as serum cholesterol levels, hypertension, and obesity.
In communities
¿ Social and economic conditions, such as poverty, employment, family composition;
¿ Culture, such as practices, norms, and values;
¿ Urbanization, which influences housing, access to products, and services.
¿ When closely examined, the diabetes have got two common risk factors like
¿ unhealthy diet
¿ physical inactivity
¿ Heredity
METHODOLOGY
STUDY DESIGN Descriptive Type
STUDY POPULATION Population above 30 years
STUDY AREA Suchindrum village
STUDY PERIOD 22nd to 26th January 2011
STUDY TOOL Structured Interview Schedule
The present study was conducted in the field practice area of rural health centre(Suchindrum Tamil Nadu), covering a population of 130 people from January 2011 by using a predesigned and pretested protocol to find out the prevalence and the risk of diabetes mellitus in general population
The study is descriptive in design, was conducted in suchindrum village in kanyakumari district. Population above 30 years was included in the study. The study population is homogenous in nature with respect of their characteristics such as Age, Health history, Nature of work, Heredity, hip measurement and give score to the individuals
During a period of 5 days from 22nd -26th January 2011 between
5-7 pm households were surveyed and the data of 130 people who are age more than 30yrs were collected by an interview schedule (Proforma) and given the score. The profoma had one component aimed at collecting socio demographic profile. All the 130 persons blood glucose level was tested by using blood glucometer.
DIAGNOSIS
The diagnosis of diabetes can be established by using any of the following criteria.
A. Fasting plasma glucose ³ 126 mg/dl after an overnight fast. This should be confirmed by repeat test.
B. Random plasma glucose RPG >200 mg/dl and symptoms of diabetes (polyuria, polydipsia, ketoacidosis, or unexplained weight loss)
C. Two hour plasma glucose ³ 200mg/dl following a 75 gram glucose or 1.75 gm/kg weight in children.
OPERATIONAL DEFNITION
Diabetes:
History of Health/age/sex/work status/family history of diabetes/hip measurement/Score of the individuals.
Household:
A person or group of persons who commonly live together and take meals from common kitchen.
RESULTS:
I. AGE –SEX DISTRIBUTION STUDY OF POPULATION
Age | Male | % | Female | % | Total | % |
30-39
| 16 | 12.3 | 15 | 11.5 | 31 | 23.80 |
40-49
| 12 | 9.2 | 16 | 12.3 | 28 | 21.50 |
50-59
| 15 | 11.5 | 14 | 10.8 | 29 | 22.30 |
60 and above | 21 | 16.2 | 21 | 16.2 | 42 | 32.40 |
Total
| 64 | 49.2 | 66 | 51.8 | 130 | 100.00 |
FIGURE I
INFERENCE
Out of the total population were 64 (49.2%) male and 66(51.8%) female. While about 23.8% were in the age group of 30-39 yrs and 21.5% were 40-49 yrs and 22.3% were 50-59 yrs and 32.4% were above 60 yrs
II. DISTRIBUTION ACORDING TO WORK STATUS
TYPE OF WORK
| FREQUENCY | PERCENTAGE |
HARD WORK
| 27 | 20.8 |
MEDIUM WORK
| 15 | 11.5 |
MILD WORK
| 42 | 32.3 |
NO WORK
| 46 | 35.4 |
TOTAL
| 130 | 100 |
FIQURE II
TYPE OF WORKS
INFERENCE
Out of the total population were 46 (35.4%) having no work person and 42(32.38%) having mild work and 27(20.8%) having hard work and 15(11.5%)
having medium work persons.
III. DISTRIBUTION ACCORDING TO PARENTS HAVING DIABETES
PARENTS HAVING DIABETIS
| FREQUENCY | PERCENTAGE |
NO DIABETIS
| 91 | 70 |
ONE PERSON
| 33 | 25.4 |
BOTH OF THEM
| 6 | 4.6 |
TOTAL
| 130 | 100 |
FIGURE III
PARENTS HAVING DIABETES
INFERENCE
Out of the total population 70% persons parents having no diabetes25.4% persons parents one of them are having diabetes and 4.6% of the persons parents both of them are diabetes
IV. DISTRIBUTION ACCORDING TO HIP MEASUREMENT
HIP MEASUREMENT
| FREQUENCY | PERCENTAGE |
BELOW 80CM
| 4 | 3.1 |
80-89 CM
| 16 | 12.3 |
90-99 CM
| 59 | 45.4 |
ABOVE 100 CM | 51 | 39.2
|
TOTAL
| 130 | 100 |
FIQURE 1V
INFERENCE
Out of the total population were 39.2% people were above 100cm hip measurement and 45.4% were between 90-99 cm and 12.3% were 80-89 cm 3.1 % were below 80cm hip measurement.
V. AGE Vs DIABETES
Age | DIABETIC | NON-DIABETIC | Total |
30-39
| 0 | 31 | 31 |
40-49
| 1 | 27 | 28 |
50-59
| 4 | 25 | 29 |
60 and above | 7 | 35 | 42 |
Total
| 12 | 118 | 130 |
FIGURE V
INFERENCE
Out of the total diabetes persons 7 diabetes persons were above 60yrs and 4 diabetes persons were between 50-59 yrs and 1 diabetes person were 40-49 yrs of age.
VI. SEX Vs DIABETES
SEX | DIABETIC | NON-DIABETIC | Total |
MALE
| 7 | 57 | 64 |
FEMALE
| 5 | 61 | 66 |
TOTAL
| 12 | 118 | 130 |
FIGURE VI
INFERENCE
Out of the total diabetes persons 7 Male persons were diabetes and 5 female persons were diabetes.
VII. SCORE Vs DIABETES
SCORE | DIABETIC | NON-DIABETIC | Total |
BELOW 30
| 9 | 39 | 48 |
ABOVE 30
| 3 | 79 | 82 |
TOTAL
| 12 | 118 | 130 |
FIGURE VII
INFERENCE
Out of the total diabetes persons were below 30 scores persons were 9 and above 30 scores were 5
VIII. WORK STATUS Vs DIABETES
TYPE OF WORK
| DIABETIC | NON DIABETIC | TOTAL |
HARD WORK
| 0 | 27 | 27 |
MEDIUM WORK
| 1 | 14 | 15 |
MILD WORK
| 5 | 37 | 42 |
NO WORK
| 6 | 40 | 46 |
TOTAL
| 12 | 118 | 130 |
FIGURE VIII
INFERENCE
Out of the total diabetes persons 6 were having no works 5 were mild works and one person was medium work.
IX. DIABETES Vs PARENTS HAVING DIABETIS
PARENTS HAVING DIABETIS
| DIABETICS | NON-DIABETICS |
NO DIABETIS
| 5 | 86 |
ONE PERSON
| 6 | 27 |
BOTH OF THEM
| 1 | 5 |
TOTAL
| 12 | 118 |
FIGURE IX
INFERENCE
Out of the total diabetes persons 5persons parents having no diabetes 6 persons parents one of them are having diabetes and one person parents both of them are having diabetes
X. DIABETES Vs HIP MEASUREMENT
HIP MEASUREMENT
| DIABETES | NON-DIABETES | TOTAL |
BELOW 80CM
| 1 | 3 | 4 |
80-89 CM
| 0 | 16 | 16 |
90-99 CM
| 4 | 55 | 59 |
ABOVE 100 CM |
7 | 44 | 51 |
TOTAL
| 12 | 118 | 130 |
FIGURE X
INFERENCE
Out of the total diabetes persons were 7 people were above 100cm hip measurement and 4 were between 90-99 cm and1was below 80 cm hip measurement
SUMMARY
No of households surveyed: 58
Total interviewed population: 130
Total number persons tested for blood sugar:130
Data from 130 responses were included in the analysis. There were 64 (49.2%) male and 66(51.8%) female. While about 23.8% were in the age group of 30-39 yrs and 21.5% were 40-49 yrs and 22.3% were 50-59 yrs and 32.4% were above 60 yrs
As per the definition used in the study the prevalence of Diabetes was present in 9.2 %
In the particular population. Proportion of Diabetes in 50-59 yrs was found to be 3.1%
And above 60yrs was 5.3%
Out of 12 persons diagnosed diabetes
Below 30 scores were nine persons (75%)
Above 30 scores were 3 persons (25%)
The person doing medium work was 1 (8.3%)
The persons doing mild work was 5 (41.6%)
The persons doing no work was 6 (50%)
The Male persons found diabetes was 7 (58.3%)
The Female persons found diabetes was 5 (41.6%)
The person found diabetes with their one of their parents were diabetes was 6 (50%)
The person found diabetes with their both of their parents were diabetes was 1 (8.3%)
The person found diabetes with no diabetes in their parents was 5 (41.6%)
The Hip measurement of below 80 cm persons was 1 (8.3%)
The Hip measurement of between 90-99cm persons was 4 (33.3%)
The hip measurement of above 100cm persons was 7 (58.33%)
CONCLUSIONS:
As per the definition used in the study the prevalence of Diabetes was present in 9.2 %.This study estimates the usefulness of simplified diabetes risk score for identifying undiagnosed high risk diabetic subjects in Suchindrum village. This simplified diabetes risk score has categorized the risk factors based on their severity.
REFERENCES:
Journal from Global Prevalence of Diabetes Estimate for the year 2000 and projections for2030 by Sarah wild ,Gojka Roglic
Indian journal of Community Medicine volume 34(3) July 2010
From Wikipedia, the free encyclopedia
PROFORMA
Screening programme for Diabetes in Suchindrum village
Name of the Street: West street
S.No | Door No | Name of the Person | Age | Sex | Total score | RBS |
Normal | High level |
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