INTRODUCTION:

Diabetes is a serious, long term condition with a major impact on lives and wellbeing of individual, families, societies and worldwide. It is among the top 10 causes of death in adults.¹

Diabetes mellitus is a syndrome characterized by a state of chronic hyperglycemia, causing disturbance of carbohydrate, fat and protein metabolism associated with absolute/relative deficiency in insulin secretion or insulin action. It is a disease caused by deficiency/diminished effectiveness of endogenous insulin¹.

In 1997, the WHO and the American Diabetes Association agreed on a new classification for diabetes mellitus. The most frequent diabetes forms are Type 1 diabetes and Type 2 diabetes, other forms of diabetes mellitus include gestational diabetes mellitus, prediabetes or impaired glucose tolerance.²

Accounting for 90% to 95% of those with diabetes, Type 2 diabetes is the most common form of the condition. It is also Known as adult onset diabetes and Non-insulin dependent diabetes mellitus (NIDDM).³

The pancreas makes insulin, but it either doesn't produce enough or the insulin doesn't work properly. As a result there is an increase in the production of insulin and this may result in insufficient levels of insulin to control sugar level in the body. So the people with Type 2 diabetes suffer from insulin resistance. Insulin resistance refers to the decreased sensitivity of the tissue to the insulin. During such a condition, the body tries to secrete more and more insulin mistaking there is lack of insulin in the body. Gradually the higher demands of insulin are not met and the pancreas struggles to produce more insulin, resulting in Type-2 diabetes.³

Normally blood glucose levels are tightly controlled by insulin. When the blood glucose elevates, insulin normalize the glucose. Insulin hormone produced by Beta cells in the Islets of Langerhans of the pancreas. The average amount of insulin secreted daily by an adult is Approximately 40to 50 units/0.6 U per kg per body weight and normal blood glucose range from approximately 70 to 120mg /dl.³

There are number of factors that influence the development of Type 2 diabetes mellitus the most influential are life style behaviors commonly associated with urbanization. The majority of cases of Type 2 diabetes could be prevented through healthy diet and regular physical activity.⁴

Over time diabetes can lead to complications like blindness, kidney failure, nerve damage and cardiac emergencies like stroke, heart attacks.³

A study by the American Diabetes Association reports that India will see the greatest increase in people diagnosed with DM by 2030. It is estimated that in the year 2000,171 million people had diabetes worldwide and it is expected to double by the year 2030 AD. Compared to Britain prevalence of Diabetes, it is higher in India. The WHO has projected the maximum increase in diabetes would occur in India.²

The survey conducted by ICMR, shows Karnataka is one of top three states in having the prevalence of pre diabetic individuals and are not aware of it until complications arise and our study aims to identify these people and bring about measures to prevent the early onset if diabetes.⁵

NEED FOR THE STUDY:

Diabetes mellitus is probably one of oldest diseases known to man. It was first reported in Egyptian manuscript about 3000 year’s ago⁶. In 1936, the distinction between Type-1 and Type-2 DM was clearly made⁷. Type-2 DM was first described as a component of metabolic syndrome in 1988⁸. Type-2 is the most common form of DM characterized by hyperglycemia, insulin resistance and relative insulin deficiency.⁹ Type 2 DM results from interaction between genetic, environmental and behavioral risk factors.^10,11

The rising burden of Type-2 diabetes is a major concern in health care worldwide. In 2017, approximately 462 million individuals were affected by Type-2 diabetes corresponding to 6.28% of the world ‘s population or a prevalence rate of 6059 cases per 1,00,000 over 1 million deaths per year can be attributed to diabetes alone making it the ninth leading cause of mortality is rising globally. And at a much faster rate in developed regions global prevalence of Type-2 diabetes is projected to increase to 7079 individuals per 1, 00,000 by 2030 reflecting a continued rise across all regions of the world.¹²

The global diabetes prevalence in 2019 is estimated to be 9.3% (463 million people) rising to 10.2% (578 million) by 2030. And 10.9% (700 million) by 2045. The prevalence is high in urban (10.8%) than rural (7.2%) areas and in high income (10.4%) than low-income countries (4.0%). One in two (50.1%) people living with diabetes do not know that they have diabetes.¹³

In 2020, according to International Diabetes Federation (IDF) 463 million peoples have diabetes in world, out of that 77 million belong to India and stand in 2^nd place in worldwide.¹²

The rapid urbanization, sedentary lifestyle, high caloric diet, visceral adiposity and high genetic predisposition have been identified as the major factors that elevate the risk of Type-2 DM among Indians at a much younger age and at a lower Body Mass Index (BMI) than the western population.¹³ Various population based studies reported that the average, onset of Type-2 DM among Indians is gradually increasing in the age groups below 50years of age.^14,15 To modify few risk factors initial identification and assessment of these risk factors becomes necessary.

The survey conducted by ICMR shows Karnataka is one of the top three states in having the highest prevalence of pre diabetic individuals with 7.5% prevalence diabetes, stands at sixth position. But it is among the top 3 when it comes to prediabetes and risk factors for non-communicable disease like abdominal obesity, HTN or dyslipidemia.⁵

According to National Family Health Survey 2015-16 at Chamarajanagara. The Prevalence % of diabetes mellitus among adults’ men 15.6% and adults women was 8.8%.¹⁷

With this background, the present study was conducted with objectives to assess the risk factors associated with development of diabetes and to educate them about lifestyle modifications to live a better life with diabetes.²

OBJECTIVES:

1. To assess the risk of developing Type 2 Diabetes Mellitus among OPD patients attending at JSS Hospital Chamarajanagara.

2. To find the association between risks of developing Type 2 Diabetes Mellitus among OPD patients attending at JSS Hospital, Chamarajanagara with their selected demographical variables.

METHODOLOGY:

Research design:

An Explorative Descriptive method has been adopted.

Setting:

The present study was conducted at JSS Hospital Chamarajanagara.

Sample and sampling technique:

By simple random sampling technique, 90 patients attending OPD at JSS Hospital Chamarajanagara were selected.

Instrument used:

Finnish Diabetic risk score.

RESULTS:

Section I: Data on demographic variables

Table I: Frequency and percentage distribution of according to the demographic variables n=90

Sl. No.	Variable	Frequency	%
1.	Age in years
	30-39 years	10	11.1
	40-49 years	32	35.6
	50-59 years	24	26.7
	60-69 years	20	22.2
	above 70 years	4	4.4
2.	Gender
	Male	62	68.9
	Female	28	31.1
3.	Occupation
	House wife	10	11.1
	Agriculture	52	57.8
	Professionals	22	24.4
	Business	6	6.7
4.	BMI
	<18.1	10	11.1
	18-24.9	42	46.7
	25-29.9	34	37.8
	30 and above	4	4.4

Among 90 participants the majority of the participants are in the age group 40-49 years and the majority of the participants are males also, the majority of the participant’s occupation is agriculture and the majority of the participants BMI is 18 to 24.9.

Section II: Level of Risk Assessment for Type-2 DM among OPD Patients

Table II: Frequency and percentage distribution of Level of Risk for type 2 DM among OPD patients n=90

Sl. No.	Risk level	Frequency	%
1	Slightly Elevated	14	15.6
2	Moderate Risk	46	51.1
3	High Risk	30	33.3
	Total	150	100

Among 90 participants 51.1% of participants are moderately risk, 33.3% of participants are high risk and 15.6% of participants are showing Slightly elevated blood sugar level. The table shows that majority of the participants are moderately risk of developing Type-2 DM.

Table III: Mean, Median and SD of Risk Scores n=90

Risk scores	No. of Items	Max Score	Mean	Median	SD
Overall	8	26	13.64	14	2.184

The data presented in Table III shows that, among 90 participants out of 8 items, maximum score obtained for screening was 26 with the mean score 13.64.

Section III: Association of the level of Risk for Type-2 Dm among OPD Patients with their Demographic Variables

Table IV: Association of the level of risk for Type-II DM among OPD patients with their demographic variables n= 90

Sl. No.	Variables	Below Median	Median and above	Chi square	Df	P value (0.05)	Inference
1.	Age in years
	a. 30-39 years	4	6
	b. 40-49 years	16	16	3.482	4	0.481	NS
	c. 50-59 years	8	16
	d. 60-69 years	12	8
	e. above 70 years	2	2
2.	Gender
	a. Male	16	46	34.842	1	0.000	S
	b. Female	26	2
3.	Occupation
	a. House wife	10	0
	b. Agriculture	30	22	31.699	3	0.000	S
	c. Professionals	2	20
	d. Business	0	6
4.	BMI
	a. <18.1	10	0
	b. 18-24.9	22	20	19.310	3	0.000	S
	c. 25-29.9	8	26
	d. 30 and above	2	2

The data presented in Table-IV shows that, association of the level of risk for Type-2 DM among OPD patients with their demographic variables and the result shows that the Gender, Age, Occupation and BMI are significant.

CONCLUSION:

The study reveals that majority of participant’s i.e. 51.1% of showing moderate risk and 33.3% of participants are showing high risk. According to study Gender, Age, Occupation and obesity are influencing factors for the risk of Type-2 DM. So, as a health professional we need to educate public regarding healthy lifestyles to prevent the risk of developing type 2 DM.

RECOMMENDATIONS:

On the basis of present study the following recommendations can be made,

1. A similar study can be taken for larger sample to generalize findings.

2. Comparative study can be conducted among rural and urban population.

3. Study recommended to conducting health education programmes on healthy lifestyles to prevent the risk of Type-2 DM.

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Received on 25.03.2021 Modified on 12.04.2021

Int. J. Nur. Edu. and Research. 2021; 9(3):297-300.

DOI: 10.52711/2454-2660.2021.00070