How good are we in detecting and screening for diabetes? Results from community-based survey in rural Puducherry, South India

Abstract

Background: Early diagnosis is the mainstay for reducing complications associated with diabetes. Though blood sugar testing was made freely available, there is gap in utilization of the same. Hence, the current study was conducted to assess the detection gap in diabetes compared to regional estimates. Also, to assess the extent of screening and factors associated with not getting screened.Methods: A community based cross-sectional analytical study was conducted in the selected rural areas of Puducherry. House to house enumeration survey was conducted in the purposively selected rural areas during September-2016 to February-2017. Information on diabetes status, status of screening in last one year was collected from individuals aged more than eighteen years. Data was entered in Epidata 3.1 and analyzed using Stata 12 software. Percentages with 95% CI were used to estimate the detection gap in diabetes on comparing with regional estimates given by IDF (8.6%). Generalized Linear Models were used to assess the individual level characteristics associated with not screening for diabetes.Results: Of the total 1844 enumerated individuals, 1423 (78.6%) were above 18 years of age. The detection gap for diabetics based on IDF was 39% and based on DLHS-4 was 69.8%. Of the eligible individuals for screening 81.9% (95% CI: 79.7%-83.9%) were not screened for diabetes in last one year.Conclusions: With high detection gap and low utilization of screening, there is need for developing innovative strategies like task shifting, ICT utilization for screening and targeted screening.