Targeted screening for prediabetes and undiagnosed diabetes in a community setting in India

Thirunavukkarasu Sathish, Jonathan E Shaw, Robyn J Tapp, Rory Wolfe, Kavumpurathu R Thankappan, Sajitha Balachandran, Brian Oldenburg

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: Data to support the use of risk scores in screening programs to detect people with prediabetes and undiagnosed diabetes in low- and middle-income countries are limited. We evaluated a targeted screening program involving a diabetes risk score in a community setting in India in terms of its uptake, yield, and costs.

METHODS: In the Kerala Diabetes Prevention Program, 2586 individuals (age 30-60 years) without known diabetes were screened using a two-step procedure. Step 1: screening with the Indian Diabetes Risk Score at participants' homes by trained non-medical staff. Step 2: oral glucose tolerance test (OGTT) among those with IDRS score ≥60 ("screen-positive") at community-based clinics. Screening costs were expressed in 2013 US dollars.

RESULTS: 96.3% of those invited for the IDRS screening consented and 79.1% of screen-positives attended clinics for an OGTT. Older age and male gender were associated with higher IDRS uptake. Female gender, higher monthly household expenditure, and higher IDRS score were associated with higher OGTT uptake. The number needed to screen (yield) to detect one person with prediabetes and undiagnosed diabetes was two and six, respectively. The average screening cost of identifying one person with prediabetes and undiagnosed diabetes was $33.8 and $116.5, respectively.

CONCLUSION: This targeted screening program had a high uptake and high yield for prediabetes and undiagnosed diabetes in a community setting in India. Alternative strategies are likely required to enhance the uptake of screening in certain groups.

Original languageEnglish
Pages (from-to)1785-1790
Number of pages6
JournalDiabetes and Metabolic Syndrome: Clinical Research and Reviews
Volume13
Issue number3
Early online date30 Mar 2019
DOIs
Publication statusPublished - 27 Jun 2019
Externally publishedYes

Bibliographical note

Copyright © 2019. Published by Elsevier Ltd.

Keywords

  • Adult
  • Biomarkers/blood
  • Blood Glucose/analysis
  • Diabetes Mellitus/blood
  • Female
  • Follow-Up Studies
  • Glucose Tolerance Test
  • Humans
  • India/epidemiology
  • Life Style
  • Male
  • Mass Screening/methods
  • Middle Aged
  • Prediabetic State/blood
  • Prognosis

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