Prevalence and Determinants of Undiagnosed Type 2 Diabetes and Prediabetes among Tribal Adults in Dadra and Nagar Haveli: A Community-Based Cross-Sectional Study
DOI:
https://doi.org/10.61336/jdme.0703.15Keywords:
Diabetes Mellitus, Type 2, Prediabetic State, Undiagnosed Diseases, Tribal Population, Indigenous Peoples, Mass Screening, Cross-Sectional Studies, IndiaAbstract
Background: Type 2 diabetes mellitus (T2DM) is rising rapidly in India, including among tribal populations traditionally considered to be at low risk. Undiagnosed diabetes and prediabetes represent missed opportunities for early intervention. Data from Dadra and Nagar Haveli (DNH), a predominantly tribal district, are lacking. We estimated the prevalence of undiagnosed T2DM and prediabetes and identified their determinants among tribal adults in DNH. Methods: In this community-based cross-sectional study, 640 Scheduled Tribe adults aged ≥18 years without known diabetes were selected by multistage sampling. A WHO STEPS-adapted questionnaire, standard anthropometry, blood pressure and fasting capillary glucose were obtained. Undiagnosed T2DM was defined as fasting glucose ≥126 mg/dL and prediabetes as 100–125 mg/dL (American Diabetes Association criteria). Multivariable logistic regression identified independent determinants. Results: The prevalence of undiagnosed T2DM was 9.7% (62/640; 95% CI 7.5–12.2) and of prediabetes 15.3% (98/640; 95% CI 12.6–18.3). Undiagnosed T2DM rose from 3.0% at 18–29 years to 17.6% at ≥60 years. Independent determinants of undiagnosed T2DM were age ≥40 years (adjusted odds ratio [aOR] 3.42; 95% CI 1.89–6.18), central obesity (aOR 2.67, 1.52–4.69), family history of diabetes (aOR 2.31; 1.18–4.52), physical inactivity (aOR 1.94; 1.11–3.39) and hypertension (aOR 1.88, 1.05–3.37). Prediabetes was independently associated with age ≥40 years, central obesity and low fruit and vegetable intake. Only 9.2% had had a blood-glucose test in the preceding 12 months; 72.5% had never been tested. Conclusion: One in four tribal adults in DNH has undetected dysglycaemia, largely linked to modifiable factors, amid very low screening coverage. Risk-stratified screening integrated with culturally tailored lifestyle interventions in primary care is urgently needed.
