Achievement of guideline recommended diabetes treatment targets and health habits in people with self-reported diabetes in India (ICMR-INDIAB-13): a national cross-sectional study

Anjana, Ranjit Mohan; Unnikrishnan, Ranjit; Deepa, Mohan; Venkatesan, Ulagamathesan; Pradeepa, R; Joshi, Shashank; Saboo, Banshi; Das, Ashok Kumar; Bajaj, Sarita; Bhansali, Anil; Madhu, Sri Venkata; Dhandhania, Vinay Kumar; Jabbar, Puthiyaveettil Khadar; Jain, Sunil; Gupta, Arvind; Chowdhury, Subhankar; Ali, Mohammed K.; Nirmal, Elangovan; Subashini, R.; Kaur, Tanvir; Dhaliwal, Rupinder Singh; Tandon, Nikhil; Mohan, Viswanathan

doi:10.1016/s2213-8587(22)00072-9

Cited by 44 publications

(42 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…India's adult population has low awareness of diabetes, which highlights the need for better health monitoring and education. Diabetes treatment and control rates are low and suboptimal 34 , especially among the poor and in rural regions, which may be due to barriers to healthcare access and price. There are low-cost glycemic medications available, but the poorest individuals cannot afford them.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have previously pointed out the need for preparedness in the primary and secondary health care centres in India, for tracking non-communicable diseases 42 . The state of healthcare remains in utter despair, where the rural counterpart is severely handicapped and marred with challenges compared to their urban counterparts 34,42 . The National Programme For Prevention And Control Of Cancer, Diabetes, Cardiovascular Diseases And Stroke (NPCDCS), is a programme set up by Government of India (GoI) to control NCDs including diabetes, which has been fruitful so far but with shortcomings too 43 .…”

Section: Discussionmentioning

confidence: 99%

“…A population-based study of 1.3 million adults carried out during 2012-2014 estimated 7.5% diabetes prevalence in India 33 . Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) which is a population-based cross-sectional study conducted in 15 states of India interpreted that the prevalence of diabetes varied widely between states and was found to be higher in low SES groups in urban areas of developed states 29,34,35 . The prevalence of diabetes in adults aged 20 years and above in India increased from 5.5% in 1990 to 7.7% in 2016 24 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Socioeconomic Inequality in Awareness, Treatment and Control of Diabetes Among Adults in India: Evidence from National Family Health Survey of India (NFHS), 2019-2021

Maiti

Akhtar

Upadhyay

et al. 2022

Preprint

View full text Add to dashboard Cite

Diabetes is a growing epidemic and a major threat to most of the households in India. There is little evidence on awareness, treatment, and control (ATC) among adults in India is limited. We estimate the prevalence and ATC of diabetes among adults across various sociodemographic groups and states of India. We used 2,078,315 individuals aged 15 years and over from the recent fifth round of National Family Health Survey (NFHS-5), 2019-21, that was carried out across all states of India. Diabetes individuals were identified as those who had random blood glucose above 140 mg/dL or taking diabetes medication or doctor diagnosed diabetes. Individuals who were measured as diabetic and (i) reported diagnosis were labelled as aware, (ii) reported taking medication for controlling blood glucose levels as treated and (iii) had measured blood glucose levels < 140 mg/dL as controlled. The estimates of diabetes prevalence, and ATC were age-sex adjusted, and disaggregated by household wealth quintile, education, age, sex, urban-rural, caste, religion, marital status, household size and state. Concentration indices was used to quantify socioeconomic inequalities and multivariable logistic regression was used to estimate adjusted differences in these outcomes. We estimated diabetes prevalence at 16.1% (15.9–16.1%). Among those with diabetes, 27.5% (27.1–27.9%) were aware, 21.5% (21.1–21.7%) were treated and 7% (6.8–7.1%) were under control. Across states of India, adjusted rates of ATC varied from 14.4% (12.1–16.8%) to 54.4% (40.3–68.4%), from 9.3% (7.5–11.1%) to 41.2% (39.9–42.6%), and from 2.7% (1.6–3.7%) to 11.9% (9.7–14.0%), respectively. Age–sex adjusted rates were lower (p < 0.001) in poorer, less educated, and social backward groups, as well as for male and residents of rural areas. Among individuals with diabetes, the richest fifth were 12.4 percentage points (pp) (11.3–13.4; p < 0.001), 10.5 pp (9.7–11.4; p < 0.001), and 2.3 pp (1.6-3.0; p < 0.001) more likely to be aware, getting treated, and having control, respectively, than the poorest fifth. The concentration index of ATC was 0.089 (0.085–0.092), 0.083 (0.079–0.085) and 0.017 (0.015–0.018) respectively. Overall, the ATC of diabetes is low in India. The ATC was much lower among adults belonging to poorer class and were less educated. Targeted intervention and management can reduce the diabetes burden in India.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Socioeconomic Inequality in Awareness, Treatment and Control of Diabetes Among Adults in India: Evidence from National Family Health Survey of India (NFHS), 2019-2021

Maiti

Akhtar

Upadhyay

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…A population-based study of 1.3 million adults, carried out during 2012–2014, estimated a 7.5% diabetes prevalence in India 34 . Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) is a population-based cross-sectional study, carried out during 2008–2015 in three phases in 15 states of India observed that the prevalence of diabetes varied widely between the states and was higher in the low SES groups in the urban areas of developed states 30 , 35 , 36 . The prevalence of diabetes in adults aged 20 years and above in India increased from 5.5% in 1990 to 7.7% in 2016 25 .…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequality in awareness, treatment and control of diabetes among adults in India: Evidence from National Family Health Survey of India (NFHS), 2019–2021

Maiti

Akhtar

Upadhyay

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Diabetes is a growing epidemic and a major threat to most of the households in India. Yet, there is little evidence on the extent of awareness, treatment, and control (ATC) among adults in the country. In this study, we estimate the prevalence and ATC of diabetes among adults across various sociodemographic groups and states of India. We used data on 2,078,315 individuals aged 15 years and over from the recent fifth round, the most recent one, of the National Family Health Survey (NFHS-5), 2019–2021, that was carried out across all the states of India. Diabetic individuals were identified as those who had random blood glucose above 140 mg/dL or were taking diabetes medication or has doctor-diagnosed diabetes. Diabetic individuals who reported diagnosis were labelled as aware, those who reported taking medication for controlling blood glucose levels were labelled as treated and those whose blood glucose levels were < 140 mg/dL were labelled as controlled. The estimates of prevalence of diabetes, and ATC were age-sex adjusted and disaggregated by household wealth quintile, education, age, sex, urban–rural residence, caste, religion, marital status, household size, and state. Concentration index was used to quantify socioeconomic inequalities and multivariable logistic regression was used to estimate the adjusted differences in those outcomes. We estimated diabetes prevalence to be 16.1% (15.9–16.1%). Among those with diabetes, 27.5% (27.1–27.9%) were aware, 21.5% (21.1–21.7%) were taking treatment and 7% (6.8–7.1%) had their diabetes under control. Across the states of India, the adjusted rates of awareness varied from 14.4% (12.1–16.8%) to 54.4% (40.3–68.4%), of treatment from 9.3% (7.5–11.1%) to 41.2% (39.9–42.6%), and of control from 2.7% (1.6–3.7%) to 11.9% (9.7–14.0%). The age-sex adjusted rates were lower (p < 0.001) among the poorer and less educated individuals as well as among males, residents of rural areas, and those from the socially backward groups Among individuals with diabetes, the richest fifth were respectively 12.4 percentage points (pp) (11.3–13.4; p < 0.001), 10.5 pp (9.7–11.4; p < 0.001), and 2.3 pp (1.6–3.0; p < 0.001) more likely to be aware, getting treated, and having diabetes under control, than the poorest fifth. The concentration indices of ATC were 0.089 (0.085–0.092), 0.083 (0.079–0.085) and 0.017 (0.015–0.018) respectively. Overall, the ATC of diabetes is low in India. It is especially low the poorer and the less educated individuals. Targeted interventions and management can reduce the diabetes burden in India.

show abstract

“…While previous studies have estimated the quality of diabetes care, estimates are reported at higher administrative levels (national and state) or among younger adults, impeding decentralized prioritization. [9][10][11][12][13] Estimates at lower administrative levels and by socio-demographic groups allow targeted solutions to improve the diabetes care continuum.…”

Section: Introductionmentioning

confidence: 99%

Diabetes diagnosis, treatment, and control in India: results from a national survey of 1.65 million adults aged 18 years and older, 2019-2021

Varghese

Mohan

Geldsetzer

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Importance Diabetes mellitus (DM) is widespread and treatable. Little is known about the diabetes care continuum (diagnosis, treatment, and control) in India, and whether it varies by socio-demographic characteristics and vary at the national, state, and district levels. Objective To estimate the diabetes care continuum among individuals aged 18-98 years old at national, state, and district-levels, and by socio-demographic group. Design Cross-sectional, nationally representative survey Setting 28 states, 8 union territories, and 707 districts of India Participants 1,895,287 approached in the Fifth National Family Health Survey (NFHS-5), 2019-2021 Exposures District, state, urban vs rural residence, age (18-39, 40-64, >=65 years), sex, household wealth quintile Main Outcomes and Measures Diabetes was defined by self-report or high capillary blood glucose (>=126mg/dL [fasting] or >=220mg/dL [non-fasting]). Of those with diabetes, we estimated proportions that were diagnosed (self-reported). Among those diagnosed, we reported the proportions treated (self-reported medication use) and proportion controlled (blood glucose <126 [fasting] or & <= 180 mg/dL [non-fasting; corresponding to HbA1c < 8%]). We benchmarked findings against the World Health Organization's Global Diabetes Compact Targets (80% diagnosis, 80% control among those diagnosed). We partitioned the variance in indicators between state and district levels using variance partition coefficients (VPC). Results Among 1,651,176 adult respondents (52.6% female; mean age: 41.6 years) with blood glucose measures, the proportion with diabetes was 6.5% (95%CI: 6.4, 6.6). Among adults with diabetes, 74.2% [73.3, 75.0] were diagnosed. Among those diagnosed, 59.4% [58.1, 60.6] reported taking medication and 65.5% [64.5, 66.4] achieved control. Diagnosis and treatment were higher in urban areas, older age groups, and wealthier households. Of the 707 districts, 34.8% districts met diagnosis target, while 10.7% districts met the control target among those diagnosed. Most of the variability in diabetes diagnosis (VPC:69.9%), treatment (VPC:51.8%), and control (VPC:66.8%) were between districts in a state, and not between states. Conclusions and Relevance Nationally, the diabetes care continuum masks considerable state- and district-level variation, as well as age- and rural-urban disparities. Surveillance at the district-level can guide state health administrators to prioritize interventions and monitor achievement of global targets.

show abstract

Achievement of guideline recommended diabetes treatment targets and health habits in people with self-reported diabetes in India (ICMR-INDIAB-13): a national cross-sectional study

Cited by 44 publications

References 27 publications

Socioeconomic Inequality in Awareness, Treatment and Control of Diabetes Among Adults in India: Evidence from National Family Health Survey of India (NFHS), 2019-2021

Socioeconomic Inequality in Awareness, Treatment and Control of Diabetes Among Adults in India: Evidence from National Family Health Survey of India (NFHS), 2019-2021

Socioeconomic inequality in awareness, treatment and control of diabetes among adults in India: Evidence from National Family Health Survey of India (NFHS), 2019–2021

Diabetes diagnosis, treatment, and control in India: results from a national survey of 1.65 million adults aged 18 years and older, 2019-2021

Contact Info

Product

Resources

About