Need for Targeted Intervention to Tackle Type 1 Diabetes Mellitus: Case Study from Gujarat, India

Special Article - Type 1 DM

Austin J Endocrinol Diabetes. 2019; 6(2): 1070.

Need for Targeted Intervention to Tackle Type 1 Diabetes Mellitus: Case Study from Gujarat, India

Yash Patel1*, Sushil Patel2, Mayur Patel1, Sandul Yasobant3 and Deepak Saxena3

¹All India Institute for Diabetes & Research (AIIDR), India

²Akshar Diabetes Centre, India

³Indian Institute of Public Health Gandhinagar, India

*Corresponding author: Yash Patel, All India Institute for Diabetes & Research, Opp. Jaymangal BRTS Bus Stop, 132 Feet Ring Road, Naranpura, Ahmedabad, Gujarat 380013, Gujarat, India

Received: October 09, 2019; Accepted: November 01, 2019; Published: November 08, 2019

Abstract

Type 1 diabetes mellitus has increased like type 2 diabetes, with a trend of 3–5% increase/year, globally. Although in India about 50.9 million people suffer from diabetes, there are no registry at grass root level for T1DM. Therefore, this study aims to develop a Comphrensive profiling of T1DM cases and understand the coping mechanism along with the knowledge & practices in the two cities of Gujarat, India. This retrospective case study on known cases of Type 1 Diabetes was conducted in two cities of Gujarat (Ahmedabad & Kutch) during March to August 2017. Out of 56 T1DM cases documented under this study, majority of them were residing in urban area. The detailed disease history, knowledge, attitude, practices, coping mechanisms, health seeking behaviors were documented.

Keywords: T12DM; T2DM

Background

In India, about 50.9 million people suffer from diabetes, and this figure is likely to go up to 80 million by 2025, making it the ‘Diabetes Capital’ of the world [1]. Type 1 Diabetes Mellitus (T1DM) (β-cell destruction, usually leading to absolute insulin deficiency) accounts for only 5–10% of those with diabetes, previously encompassed by the terms insulin-dependent diabetes, type I diabetes, or juvenile-onset diabetes, results from a cellular-mediated autoimmune destruction of the -cells of the pancreas [2]. T1DM has increased like type 2 diabetes, with a trend of 3–5% increase/year [3]. The exact cause of T1DM is not known. Most likely, it is an autoimmune disorder also; it can be passed down through families [4]. The prevalence of T1DM in children is 111,500 and it’s estimated that India is housing about 97,700 children with T1DM [5]. India has three new cases of T1DM per 100,000 children of 0–14 years, however; prevalence data shows 17.93 cases/100,000 children in Karnataka, 3.2 cases/100,000 children in Chennai, and 10.2 cases/100,000 children in Karnal (Haryana) [6].

The Indian Council of Medical Research funded Registry of People with diabetes, this registry is by government and called ICMR registry. It was started in the year 2006 with 10 collaborating centers across India and this registry mainly focused to provide an overview of diabetes in the young [7]. Usually an ideal disease for establishing the registry is a disease with sufficient public health importance and diabetes mellitus could be considered as an ideal disease to establish such a registry. As per the International Diabetic Federation, there is a need to revamp the preventive, promotive and appropriate curative modalities for it [8]. However, people with Diabetes with Young Age at Onset (YDR) was major focus in the registry at national or state level; there is a strong recommendation to develop a local level T1DM registry to understand the disease dynamics at different geographic level [9,10].

Therefore, this study aims to develop a Comphrensive profiling of T1DM cases and understand the coping mechanism along with the knowledge & practices in the two cities of Gujarat, India.

Materials & Methods

This retrospective case study on known cases of Type 1 Diabetes was conducted in two cities of Gujarat (Ahmedabad & Kutch) during March to August 2017. The two sites were sampled purposefully where a lead diabetic NGO was providing health care services for more than a decade. The samples included in case were enrolled with NGO for screening of complications, routine treatment and treatment of complications, counselling and dietary advice. Secondary data analysis of the line listed cases was undertaken and were contact either in person of through telephone; a camp based for further contact was also adopted as a method to seek further insights into the morbidity profile of the cases. On a specified day, the camp was conducted on both the sites; all the T1DM patients were enrolled voluntarily with a prior written consent. A total of 56 T1DM cases participated in the camps and hence are included in the this case study. A structured questionnaire was developed primarily in English and translated into vernacular language (Gujarati) and validated / pretested before being administered to the cases included in the study; to ensure uniformity in data collection, three data collectors with nursing and public health back ground were hired and trained and they administered this questionnaire and documented some of physical & biological parameters. The questionnaire focused on collecting information on socio-demographic, disease history, difficulties & coping mechanism with T1DM, knowledge, attitude & practices, health seeking behavior & treatment. Data were entered in the excel spreadsheet and descriptive analysis was conducted in SPSS version 20.

Results

Socio-demographic profile

Out of 56 T1DM cases documented under this study, majority (77%) of them were residing in urban area. More than half of participants were in the productive age group of 15-29 years. The mean age of participants was 21±10 yrs. Minimum and maximum age of participants were respectively 3 and 56 yrs (median age=23). The male and female proportion was approximately same 52% and 48% respectively. Almost all of them were literate up to higher secondary or more. About 39% of participants were students. Social stratification of participants show that majority of participants belonged to general class, only 3.6% was form schedule caste. Out of all, 37% participants were married (Table 1).