Screening for Diabetes: Results from a Large Ongoing Community Based Screening Programme in India

"The burden of diagnosed and undiagnosed diabetes is high and increasing rapidly in India. We implemented a community based diabetes screening programme in epidemiologically transitioning and culturally distinct urban and rural areas of North (Sonipat, Haryana) and South (Visakhapatnam, Andhra Pradesh) India. All adults aged ≥ 30 years residing in the aforementioned areas were eligible for screening. Data were obtained by trained health workers (HWs) using an interviewer administered questionnaire, anthropometry and capillary blood glucose test. Risk of diabetes was assessed using a validated risk score incorporated into an android application. Adults with score of > 16 or fasting capillary blood glucose of ≥ 126 mg/dl or random capillary blood glucose of ≥ 200 mg/dl were classified being at high risk for developing diabetes. High risk adults were provided with lifestyle advice for risk reduction and linked to the health system for further management. The mean age of the participants was 48 years. Since January 2015, 133211 adults (57112 in Sonipat and 76099 in Visakhapatnam; 79888 women and 53323 men) have been screened. Among the 122646 adults (10565 self-reported diabetics excluded), 55% were found to be at high risk. The proportion of high risk adults was higher among urban residents. The high risk adults are being followed up by the HWs on bi-monthly basis to track their management and provide lifestyle advice for risk reduction. Community and health system engagement, stakeholder involvement, mass and mid-media campaign, refresher trainings and constant motivation of HWs were crucial to successfully implementing this programme. Diabetes, non-communicable diseases, screening Key Messages: 1. The number of adults at high risk for developing diabetes is very high in India. 2. The screening programme has helped identify hitherto undiagnosed adults with high risk and link them to the health system for evaluation and appropriate management. 3. The screening programme will contribute to early diagnosis, improved management and improved health outcomes. "

Nikhil Srinivasapura Venkateshmurthy

Public Health Foundation of India