Risk of Developing Diabetes in The Indian Youth: An Evaluation Using Indian Diabetes Risk Score (IDRS)

International Journal of Medical and Health Research

ISSN: 2454-9142, Impact Factor: RJIF 5.54
www.medicalsciencejournal.com
Volume 3; Issue 5; May 2017; Page No. 17-19
Risk of developing diabetes in the Indian youth: An evaluation using Indian diabetes risk score (IDRS)
1
Dr. Shweta Sahai, 2 Dr. Nishtha Ahuja
1
Assistant Professor, Department of Medicine, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
2
PG Student, Department of Pathology, PGI, Chandigarh, Punjab, India
Abstract
Background: Prevalence of type 2 diabetes mellitus (T2DM) has increased beyond the proposed value in India; hence it is very
necessary to screen population to recognize T2DM patients earlier to prevent associated complications.
Aims and objective: To evaluate and spread the awareness regarding risk for type 2 diabetes mellitus using Indian Diabetes Risk
Score (IDRS)
Materials and Methods: A cross sectional study on 100 students having age between 18-25 years of either sex was performed on
students of Madhav Institute of Technology and Science (MITS), Gwalior. Age, sex, waist circumference, details of physical
activities and family history of diabetes were recorded by giving a questionnaire to each student. All the participants were assessed
using pre-validated IDRS questionnaire based on that risk was calculated as high (≥60), moderate (30-50) and low risk (<30.)
Results: Male predominance was observed (76%) in present study. Out of 100 subjects among male, 56 (73.68%) and 20 (26.31%)
has moderate and low risk for developing diabetes mellitus whereas all the females of study cohort have moderate risk of developing
diabetes. None of subject had high risk of diabetes development.
Conclusion: IDRS is an effective tool to screen high risk individual in order to design strategies for future prevention and delay
type 2 diabetes mellitus onset.
Keywords: type 2 diabetes mellitus, prediabetes, risk score
Introduction Materials and Methods

Diabetes mellitus was once considered the disease of old age Present cross sectional study was done on 100 subjects at
but now it is so common among all age groups that now being Madhav Institute of Technology and Science (MITS), Gwalior,
diagnosed in adolescent and even children. Individual with from November 2013 to January 2014. The present research
impaired fasting glucose (fasting blood glucose between 100 protocol is approved by the College Ethical Committee and
to 125 mg/dl) and/or impair glucose tolerance (2 hour oral written informed consent from each participant was obtained
glucose tolerance test value between 140 to 199 mg/dl) is before starting study.
considered as prediabetes [1]. Such patients are at high risk for In anthropometric measurement waist circumference (that
developing diabetes mellitus in near future. According to indicates both central as well as general obesity) was measured
international diabetes federation 11% individual with using measuring tape. Measurements of the waist was done
prediabetes develop type 2 diabetes mellitus every year. directly on the body with light clothing with accuracy of 0.5
In Indian individual’s diabetes mellitus is diagnosed almost a cm. Waist circumference was taken at the midpoint between
decade earlier than in western population. Moreover, the the iliac crest and the lower border of the ribs after a normal
treatment cost of diabetes mellitus in an economically week expiration.
family may utilize as much as 25% of the entire income of each Students having age between 18-25 years of either sex and
individual with diabetes. But prediabetes is a reversible those who have given written informed consent were included
condition [2]. in the present study. Established cases of diabetes mellitus,
The Indian Diabetes Risk Score (IDRS) was devised by the subjects with hypertension, coronary heart disease, thyroid
Madras Diabetes Research Foundation. It is an effective abnormality and administration of corticosteroid were
diabetes screening tool which takes in to account of family excluded from the present study.
history, waist circumference, age and physical activity of the The intention of the study was thoroughly explained to each
individual [3]. Hence, individual with high risk of developing participant. All the participants were assessed for IDRS which
diabetes mellitus in near future can be identified and systematic needs answers for three questions and waist measurement.
counseling and further interventions can be applied in order to Scores to all the subjects were awarded based n their physical
reduce diabetes related complications [4]. activity viz. sedentary, mild, moderate, vigorous exercise or
The present study was done to evaluate and spread the strenuous work. Other parameters were also assessed based on
awareness regarding risk for type 2 diabetes mellitus using table 1. Risk Interpretation was done as high, moderate and low
IDRS of MITS College, Gwalior having age group 18-25 yrs. risk if their IDRS score is ≥60, 30-50 and <30 respectively.
17
Table 1: Indian Diabetes Risk Score (IDRS) was 24%, 56% and 16% as high, moderate and low
Particulars Score respectively which is in accordance with the present study
Age (years) where most of the subjects had moderate risk.
< 35 0 Anjana et al. studied role of parental history of T2DM in Asian
35 – 49 20 Indian adolescents and reported that family history of subjects
≥ 50 30 itself increase the risk of T2DM development by 4-6 times [9].
Abdominal obesity Hence, subjects’ family history along with other risk factors of
Waist <80 cm [female], <90 [male] 0 IDRS can put the individual at high risk of developing T2DM.
Waist ≥ 80 – 89 cm [female], ≥ 90 – 99 cm [male] 10 Since family history is one of the non modifiable risk factor,
Waist ≥90 cm [female], ≥ 100 cm [male] 20 attempts should be made to reduce weight and intense exercise.
Physical activity This can be an important strategy for preventing T2DM
Exercise [regular] + strenuous work 0 development.
Exercise [regular] or strenuous work 20 Sharma et also analysed data of 8747 subjects records to study
No exercise and sedentary work 30 IDRS to distinguish T2DM from non-T2DM concluded that
Family history IDRS is a simple and cost effective risk assessment tool which
No family history 0
can aid in distinguishing T2DM from non-T2DM among clinic
Either parent 10
patients in India [7].
Both parents 20
Taken from Patel et al. (Patel et al. 2015)
Nagalingam et al. conducted a house to house survey in
Chennai and out of that randomly chosen not known diabetic
Results adults having age more than 20 years were studied.
Out of 100 subjects, 76% were male and 24% were female. Nagalingam et al. reported 18%, 45% and 37% adults had low,
medium and high risk for developing T2DM respectively
Table 2: Distribution of students according to waist circumference according to IDRS score which is in accordance to present
study data [10]. Present study had few limitations such as sample
Sex A B C Total size was small and was focusing only single centre.
Male 70 (92.10) 4 (5.26) 2 (2.63) 76 (100)
Female 18 (75) 6 (25) 0 (0) 24 (100) Conclusion
Each individual having age ≥18 years should be assessed for
Data is expressed as no of subjects (%), A= < 80 cm (Female), the risk of developing diabetes mellitus by calculating the
<90 cm (Males), B=80-89 cm (Females), 90-99 cm (Males), IDRS to identify future risk of T2DM. It will not just aid in
C=>90 cm (Females), >100 cm (Males) early detection and prevention of complications but will also
Out of 100 subjects, 24% male did regular physical exercise in reduced morbidity and mortality caused by T2DM.Hence
their daily routine life, 74% did not follow regular physical IDRS can be used to motivate people for primary prevention of
exercise. None of the female subjects followed regular physical diabetes, metabolic syndrome and cardiovascular disease.
exercise. Eighty four percent subjects has no family history of
diabetes, 14% had one parent family history whereas none of References
the subjects had two parent family histories. 1. Lindstorm J, Neumann A, Sheppard KE, Gills-
Januszewska A, Greaves CJ, Hande U. et. Take Action to
Table 3: Distribution of students with IDRS score
prevent diabetes – the IMAGE Toolkit for the prevention
<30 (low 30-50 (moderate ≥60 (high of type 2 Diabetes in Europe. Horm metab Res. 2010;
Sex Total
risk) risk) risk) 42:S37-S55.
Male 20 (26.31) 56 (73.68) 0 (0) 76 2. Mehta SR, Kashyap AS, Das S. Diabetes Mellitus in
Female 0 (0) 24 (100) 0 (0) 24 Indian: the Modern Scorge. MJAFI. 2009; 65:50-54.
Data is expressed as no of subjects (%) 3. Mohan V, Deepa R, Deepa M. A simplified Indian
Diabetes Risk Score for screening undiagnosed diabetic
In present study, prevalence of subjects at moderate risk of subjects. J. Assoc. of Physicians of India. 2005; 53:759-
developing type 2 diabetes mellitus in future whereas 763.
prevalence of low risk was 20%. None of the subjects were 4. Vardhan A, Prabha A, Shashidhar MK, Saxena N, Gupta
found to have high risk of type 2 development. All the subjects S, Tripa A. The Value of the Indian Diabetes Risk Score
with family history of diabetes mellitus were found to be at as a Tool for Reducing the Risk of Diabetes among Indian
moderate risk for developing type 2 diabetes mellitus. Medical Students. Journal of Clinical and Diagnostic
Research. 2011; 5(4):718-20.
Discussion 5. Patel S, Tyagi A, Waran M, Garudkar S, Telang S.
IDRS is simple and cost effective screening tool for which is Evaluation of Risk for Type 2 Diabetes Mellitus in
widely used by a primary care physician or healthy worker to Medical Students Using Indian Diabetes Risk Score
identify the risk of developing diabetes mellitus [5, 6]. (IDRS). Sch J App Med Sci. 2015; 3(6B):2298-300.
Sensitivity and specificity of IDRS as reported by Sharma et al 6. Shobha MV, Deepali A. Indian Diabetic Risk Score
and Stanely et al. is 72.5 and 60.1% respectively [7, 8]. (IDRS): A novel tool to assess the risk of Type 2 Diabetes
Shobha et al. assessed the risk of developing T2DM using Mellitus. Indian Journal of Basic and Applied Medical
IDRS in 216 subjects having age between 20-40 years reported Research. 2016; 5(4):106-10.
that risk of T2DM development increases with age in all risk 7. Sharma KM, Ranjani H, Nguyen H, Shetty S, Datta M,
score groups [6]. Prevalence of risk reported by Shobha et al. Venkat Narayan K et al. Indian Diabetes Risk Score Helps
18
to Distinguish Type 2 from Non-Type 2 Diabetes Mellitus

(GDRC-3). JDST. 2011; 5(2):419-25.
8. Stanley L, Elantamilan D, Mohanasundaram K,
Kumaravel TS. Evaluation of Indian diabetic risk score for
screening undiagnosed diabetes subjects in the
community. Indian Journal of Science and Technology.
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9. Anjana RM, Lakshminarayanan S, Deepa M, Farooq S,
Pradeepa R et al. Parental history of type 2 diabetes
mellitus, metabolic syndrome, and cardio metabolic
factors in Asian Indian adolescents. Metabolism Clinical
and Experimenta. 2009; 58:344-50.
10. Nagalingam S, Sundaramoorthy K, Arumugam B.
Screening for diabetes using Indian diabetes risk score. Int
J Adv Med. 2016; 3:415-8.
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International Journal of Medical and Health Research

International Journal of Medical and Health Research

Keywords: type 2 diabetes mellitus, prediabetes, risk score

Introduction Materials and Methods

to Distinguish Type 2 from Non-Type 2 Diabetes Mellitus

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