diabetes study

1. Prevalence, Awareness, Treatment and
Control of Diabetes Among Elderly Persons
in an Urban Slum of Delhi
Arvind Kumar Singh, Kalaivani Mani, Anand Krishnan, Praveen
Aggarwal, Sanjeev Kumar Gupta
Presented By
Dr. Chetan Sharma

2. • prevalence of diabetes suggested that nearly 3%
of adults were diabetic in the year 2000, and this
figure is projected to be nearly doubled by the
year 2030*
• Diabetes also contributes to 5% of the total
mortality.#
• demographic transition is due to increase in the
number of aged persons, leading to an increase in
the prevalence of hypertension and diabetes.^

3. • Undiagnosed diabetes is associated with
increased risk of all-cause mortality.
• Low-socioeconomic status is associated with
development of diabetes.

4. Materials and Methods
• This was a cross-sectional study among elderly
persons aged 60 years and above.
• The sample size was estimated based on a
multicenter study carried out in 10 cities of
India, which reported the prevalence of
diabetes among the elderly persons as 13.4%.
• All participants were interviewed in the local
language, at their homes.

5. • Fasting blood sugar was estimated using an
Eukare R automated glucometer.
• Diabetes was diagnosed if the fasting blood
glucose was ≥126 mg/dL (≥7.0 mmol/L) after an
overnight fast for at least 8 hours.
• The awareness status regarding their own
diabetes mellitus was defined as having diabetes
diagnosed by a health professional with presence
of a prescription, or anti-diabetic medicines
possessed by the participant.

6. • The treatment status was defined as taking
any pharmacological treatment for diabetes.
Participants who were already diabetic and
taking treatment were considered to have
control if the fasting blood glucose was <126
mg/dL.
• Of the 496 participants who were interviewed,
22 (4.4%) refused for fasting blood sugar
estimation.

7. • None of these 22 persons had any prescription
for anti-diabetic medicines. Hence, fasting
blood sugar testing was done in 474 (95.6%)
of the 496 participants.
• Fifty-two percent of the participants were
male. About four-fifths of the participants
were aged less than 70 years [Table 1]. The
mean age was 65.0 years

8. Table 1: Demographic characteristics
of the participants

9. • The prevalence of impaired blood glucose was
estimated to be 19.8% (95% CI 16.3-23.7). It
was 19.2% (95% CI 14.4-24.7) and 20.5% (95%
CI 15.5-26.3) among men and women,
respectively.
• About one-third (36.0%) of the 89 diabetics
were aware of their condition.

10. • Of those participants who were aware, more
than half were on treatment.
• Of those on treatment, three- fourth had
controlled fasting blood sugar [Table 3].

11. Table 3: Participants with diabetes who were
aware, treated and controlled

12. Discussion
• The prevalence of diabetes was estimated to
be 18.8% in the present study.
• Studies from India have reported a prevalence
from 13% to 25%, which is comparable.
• Decrease in the prevalence of diabetes with
increasing age in the present study could be
due to a survival bias.

13. • On an average, every fifth elderly person was
identified as having impaired fasting blood
glucose.
• This is a pre- diabetic condition.
• institution of dietary and lifestyle
modifications may prevent or delay
progression to diabetes in this group.

14. • 62.5% of those who were aware that they had
diabetes were taking treatment.
• The awareness, treatment and control were
better among women.
• Among elderly persons, the prevalence of
diabetes was found to be comparable to
previous reported estimates.
• the awareness level in them regarding its
presence was low.

15. • Screening, diagnosis and proper treatment of
diabetes is required for elderly persons.
• Because they may be unable to visit the fixed
health facility due to dependency on family
members.
• Strengthening primary health care services in
urban slums, with special emphasis on the
vulnerable population like elderly persons, is
needed.