ARTICLE

PRESENTATION
MAJ NEETHU A
MSc (N) I YR.
(COMMUNITY HEALTH NURSING)
CON, CH (EC), KOLKATA
 TITLE OF THE STUDY

• Assessment of risk of diabetes by using Indian Diabetic risk score

(IDRS) in Indian population
 JOURNAL –DIABETES RESEARCH AND CLINICAL PRACTICE

• The official journal of the International Diabetes Federation

• Published by Elsevier publications
• DOI: 2020-04-01,
• Volume 162,
• Article 108088 -108180, Copyright © 2020 Elsevier B.V.
• ISSN : 01688227, 18728227
• Impact Factor -8.18
JOURNAL –DIABETES RESEARCH AND CLINICAL PRACTICE

• International journal for health-care providers and clinically oriented

researchers that publishes high-quality original research articles and
expert reviews in diabetes and related areas.
• Topics of focus include translational science, genetics, immunology,
nutrition, psychosocial research, epidemiology, prevention, socio-
economic research, complications, new treatments, technologies and
therapy.
 JOURNAL –DIABETES RESEARCH AND
CLINICAL PRACTICE

• Language of publication: English

• Received 7 December 2019
• Accepted 18 February 2020
• Available online 19 February 2020
 AUTHORS
• Raghuram Nagarathna
• Rahul Tyagi
• Priya Battu
• Amit Singh
• Akshay Anand
• Hongasandra Ramarao Nagendra
 ABSTRACT
The abstract consists of 4 paragraphs which includes
• Introduction
• Aim -To screen the Indian population for Type 2 Diabetes Mellitus (DM)
based on Indian Diabetes Risk Score..
• Methods
• Results
• Discussion
 KEY WORDS

• T2DM
• Diabetic Yoga Protocol
• IDRS
• Diagnosis
• DYP
 INTRODUCTION
• As per the International Diabetes Federation (IDF), the number of people with Type
2 Diabetes (DM) is increasing in each country.

• Mortality & Co-morbidities associated with Diabetes go unidentified because of late

diagnosis and delay in initiation of therapy.

• This is largely preventable by early diagnosis of DM and increasing awareness about

the disease both in public as well as among the health-care providers.
 INTRODUCTION

• The Indian Diabetes Risk Score (IDRS), has been emerged as a simple screening tool
for prediction of undiagnosed DM

• Developed by Mohan et al. at the Madras Diabetes Research Foundation (MDRF),

Chennai.

• Derived from the Chennai Urban Rural Epidemiology Population Study (CURES)
• Validated using the data from the Chennai Urban Population Study.
 INTRODUCTION
• Tool

• Indian Diabetes
Risk Score(IDRS)
Min score : 0
Max score : 100
High risk : greater than or equal to 60
Moderate risk : 30 to 50
Low risk : 0 to 30
 OBJECTIVE
• To assess the prevalence of Type 2 Diabetes Mellitus in selected Indian

population

• To assess the risk factors associated with Type 2 Diabetes Mellitus in selected

Indian population.

• To assess the association of Indian Diabetic risk score (IDRS) and risk factors of

diabetes mellitus type 2 in subjects of Indian population

 MATERIALS AND METHODS
• Research approach : Stratified translational research study

• Research design :Non experimental descriptive research

• Setting :All populous states and Union territories of India in 2017

• Population :Populations from all zones of rural and urban

India

• Sample :All men and women above 20 years

• Sampling technique : Consecutive sampling

 SAMPLING
Probability proportionate stratified random sampling
Inclusion criteria
• All men and women of age 20 yrs and above

Exclusion criteria
• Not given
.
 SAMPLING
• Steps

• Formulation of international research advisory committee of 16 experts

• Random selection of districts(1/10) from all states /union territories

• Random selection of clusters of urban and rural areas across India

• Population of 4000/district (50 % rural & 50% urban)were screened in the first phase

• Screening by 1200 trained field volunteers(20/ district)

 RESULTS

Table 2: Demographic details

 RESULTS

Table 3: The highest %(33 %) of high risk population was in Northwest zone (Jammu)
The least % (15 %) was in East zone
Subjects of urban areas were at high risk than the rural areas.
 RESULTS

Table 4: Majority of the known DM Subjects were found in high risk group (78.1%)
Nort Western region(62.9) has the highest prevalence followed by South India(55 % )( urban)
North Indian rural region has the highest prevalence of DM subjects (50.1 %)
 RESULTS

Highest no of population under high risk falls under the age group 50 to 59
Lowest no falls under the age group < 20
RESULTS
 RESULTS
Prediction of self
reported diabetes
through IDRS was found
to be positively
significantly associated
with
odds ratios 1.782 & 2.686
 DISCUSSION
• IDRS score distribution showed higher prevalence of DM patients falling into
high risk group. >50 cut off youden index showed the sensitivity of 78.05 and
specificity of 62.68 which approves the utility of IDRS as a cost effective tool.
IDRS tool based on this study findings have public health implications.
Moreover method can be utilized by the practicing clinicians in early
diagnosis of DM.
 FUNDING
• This research was funded by Central Council for Research in Yoga and

Naturopathy (CCRYN), New Delhi (Ref F.No. 16-63/2

016-17/CCRYN/RES/Y&D/MCT/Dated: 15.12.2016).
 AKNOWLEDGEMENT
The authors acknowledged Ministry of AYUSH,Govt of India, NewDelhi, for
funding this project. They also acknowledged support of CCRYN for
manpower, MOHFW for supporting the cost of investigations and IYA for the
overall project implementation. They also thanked the advisory research
committee, senior research fellows, Mr Sabzar, Dr Sanjay, Ms Radhika, Dr
Sunanda Rathi, Yoga volunteers and the President of Indian Yoga Association
for their contribution in this project.
 NEW LEARNING
• STRATIFIED TRANSALATIONAL RESEARCH

• Translational research (also called translation research, translational science,

or, when the context is clear, simply translation)

• Research aimed at translating (converting) results in basic research into results

that directly benefit humans.

• The term is used in science and technology, especially in biology and

medical science. As such, translational research forms a subset of applied research.
 NEW LEARNING
• Odds ratio

• Ratio of the number of people with the event to the number without.

• A common interpretation for odds ratios is identifying risk factors by

assessing the relationship between exposure to a risk factor and a medical
outcome.

• For example, is there an association between exposure to a chemical and a

disease?
NEW LEARNING
 NEW LEARNING

• Youden’s Index
• Youden's J statistic (also called Youden's index) is a single statistic that captures
the performance of a dichotomous diagnostic test
NEW LEARNING
The diagnostic test is 75 %
accurate in detecting the
proportion of patients
with positive test results

&
55 %
 NEW LEARNING
• Youden Index

Ranges between 0 and 1,

• with 0 values indicating that a diagnostic test gives the same proportion of
positive results for groups with and without the disease.

• A value of 1 indicates that there are no false positives or false negatives.

• The closer the value is to 1, the better the test’s performance.