Sandhya, G I (2007) Does Fasting Blood Sugar Predict Risk of Developing Diabetes for Next 15 Years - A Cohort study. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION : The last century has witnessed the epidemiologic transition among many populations, Which has resulted in a decrease in infectious disease, with a concomitant increase in Chronic non communicable diseases, such as cardiovascular disease, cancer, and diabetes. At any given time, different countries in the world or even different regions within a Country are at different stages of the epidemiologic transition. In developing countries Like India, the increased incidence of non communicable diseases adds to the continuing Burden of infectious, nutritional, and perinatal diseases, which has been termed the Double-burden of diseases. Type 2 Diabetes, a global public health problem, is now emerging as a pandemic. Prevalence of diabetes in adults worldwide was estimated to be 4.0% in 1995 and to rise To 5.4% by the year 2025. Much of this increase in diabetes will occur in developing Countries, due to population growth, ageing, unhealthy diets, obesity and sedentary Lifestyles. Thus, by the year 2025, 75% of people with diabetes will reside in developing Countries, as compared with 62% in 1995. In developed countries, most people with Diabetes are above the age of retirement. In developing countries, those most frequently Affected are in the middle, productive years of their lives, aged between 35 and 64.1 India has highest prevalence of diabetes among Asian countries. It is estimated That there are approximately 33 million adult currently with diabetes in India. This Number is likely to increase to 57.2 million by the year 2025. A large number of cross Sectional studies are reported in different states of India but there are no incidence Studies done in India to estimate annual risk of new cases. AIM AND OBJECTIVES : To estimate the predictive validity of fasting plasma glucose in risk of future type 2 Diabetes in a rural south Indian population aged 30-60 years over time. 1. To determine the risk`of progression from normoglycemia to type 2 diabetes Based on the fasting plasma glucose (FPG) concentration among a cohort of rural people Aged 30-60 years in Kaniyambadi block over a period of 15 years. 2. To measure association of selected risk factors and the probability of Developing type 2 diabetes mellitus in Kaniyambadi block over a period of 15 years. SUMMARY AND CONCLUSION : The objective of this cohort study was to estimate the predictive validity of fasting plasma glucose in risk of future type 2 diabetes. Some selected risk factors for future diabetes was also studied. The annual incidence of diabetes in the study cohort by ADA criteriea FPG>=126mg/dl was studied and by WHO criteria that is either FPG>=200mg/dl or OGTT>= 200mg/dl was also studied. This study shows that males are at higher risk of developing future diabetes than females. This study also shows that age is not a significant predictor of future diabetes as baseline prevalence study has shown. After simultaneous adjustments for confounders using multivariale analysis baseline fasting plasma glucose remained as a significant predictor of future type 2 diabetes in a rural population aged 30-60. The risk associated withFPG increases from 100ml/dl and highest risk is for the group with FPG 110-125 mg/dl. The result of this study strongly supported ADA’s concept of impaired fasting glucose. This study also showed that the revised classification of impaired fasting glucose [100 mg/dl-125 mg/dl] is applicable for a south Indian rural population aged 30-60 years. The present study calculated projected cumulative incidence of the baseline cohort and it showed at least four fold increase in the burden.of the disease.Other significant predictors were sex, baseline cholesterol >=200 mg/dl and systolic blood preasure >=140mg./dl,diastolic blood pressure >=90mg/dl ,BMI>=25kg/m2 and abdominal obesity(male>=85cm and female>=80cm.) .Risk factrors like physical activity, socioeconomic statusand age were proved as nonsignificant in multivariate analysis.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Fasting; Blood Sugar ; Predict Risk ; Developing ; diabetes ; Cohort study. |
| Subjects: | MEDICAL > Community Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Jul 2017 06:10 |
| Last Modified: | 12 Jul 2017 06:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1195 |
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