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. 2019 Jun 24;19(1):817.
doi: 10.1186/s12889-019-7184-4.

Prevalence of diabetes and pre-diabetes in rural Tehri Garhwal, India: influence of diagnostic method

Pam Anderson  1 , Nathan Grills  1 , Rajesh Singh  2 , Rajkumari Singh  2 , Roger G Evans  3 , Paramita Sengupta  4 , Amanda G Thrift  5
Affiliations

Prevalence of diabetes and pre-diabetes in rural Tehri Garhwal, India: influence of diagnostic method

Pam Anderson et al. BMC Public Health. .

Abstract

Background: There are few available data regarding the prevalence of diabetes in the sub-Himalayan region of India. The aim of this study was to determine the prevalence of pre-diabetes and diabetes in rural Garhwal based on glycosylated hemoglobin.

Methods: In a cross-sectional survey of 500 adults from five randomly selected villages in Chamba, a mountainous Tehri Garhwal district in Uttarakhand in north-west India, we determined the prevalence of diabetes (hemoglobin (Hb) A1c ≥ 6.5%) and pre-diabetes (5.7% ≤ HbA1c ≤ 6.4%). In a sub-sample of those diagnosed with diabetes or pre-diabetes (n = 140), fasting blood glucose (FBG, n = 117) or postprandial blood glucose (PBG, n = 23), and blood hemoglobin concentration, was measured at follow-up.

Results: Based on HbA1c, 10.0% had diabetes and 56.4% pre-diabetes. Of those diagnosed as diabetic by HbA1c, 10 of 16 (62.5%) were diagnosed as diabetic by FBG (> 125 mg/dL) or PBG (≥200 mg/dL). In those diagnosed as pre-diabetic by HbA1c, only 55 of 124 (44.4%) were diagnosed as pre-diabetic by FBG (100-125 mg/dL) or PBG (140-199 mg/dL). A large proportion of these 140 individuals (67.1%) were moderately to severely anemic (Hb < 11.4 mg/dL). The diagnostic gap for pre-diabetes between HbA1c and FBG/PBG was similar for the groups with and without moderate to severe anemia.

Conclusions: HbA1c and FBG/PBG have similar diagnostic performance for diabetes in this population. However, many individuals were diagnosed with pre-diabetes by HbA1c but not FBG/PBG. The relative excess diagnosis of pre-diabetes with HbA1c does not appear to be explained by anemia, an endemic condition in India. The prognostic significance of diagnosis of pre-diabetes by HbA1c but not FBG/PBG remains unknown, but merits investigation.

Keywords: Anemia; Diabetes; Disadvantage; Fasting blood glucose; Glycosylated hemoglobin.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study Flow Diagram. *HbA1c at Time 1 was missing for 1 case, Average interval between Time 1 and Time 2 = 100 days, HbA1c: Glycosylated hemoglobin, FBG: Fasting blood glucose, PBG: Post-prandial blood glucose
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References

    1. Roglic G, Unwin N. Mortality attributable to diabetes: estimates for the year 2010. Diabetes Res Clin Pract. 2010;87:15–19. doi: 10.1016/j.diabres.2009.10.006. - DOI - PubMed
    1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–1053. doi: 10.2337/diacare.27.5.1047. - DOI - PubMed
    1. Misra P, Upadhyay RP, Misra A, Anand K. A review of the epidemiology of diabetes in rural India. Diabetes Res Clin Pract. 2011;92:303–311. doi: 10.1016/j.diabres.2011.02.032. - DOI - PubMed
    1. Anjana RM, Deepa M, Pradeepa R, Mahanta J, Narain K, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR-INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017;5:585–596. doi: 10.1016/S2213-8587(17)30174-2. - DOI - PubMed
    1. Kumar PR, Bhansali A, Ravikiran M, Bhansali S, Dutta P, Thakur JS, et al. Utility of glycated hemoglobin in diagnosing type 2 diabetes mellitus: a community-based study. J Clin Endocrinol Metab. 2010;95:2832–2835. doi: 10.1210/jc.2009-2433. - DOI - PubMed