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THE PHARMA REVIEW (APRIL - MAY, 2008)

Prevalence of Diabetes Mellitus in Patient Population of Dehradun

Yogesh Joshi, Reena Pant, Piyush Mittal, Vijay Juyal, Dr. A. C. Agrawal

Abstract: The number of people with diabetes is increasing due to population growth, aging, urbanization, and increasing prevalence of obesity and physical inactivity. Diabetes mellitus is highly prevalent disease in India and the current data on nationwide survey are not sufficient. The present study was envisaged with the aim of collecting data from diabetes of Dehradun. The study was carried out on out-patients in different hospitals of Dehradun by collecting the information such as patient's name, age, sex, weight, height, occupation, socioeconomic parameter, lifestyle, food habits, past medical history, disease diagnosed, duration of disease and risk factor. Out of 300 patients, 60% were males and 40% were females indicating the prevalence of diabetes mellitus more in male patients than that of female patients. The age wise prevalence of diabetes mellitus in male patients was found to be higher than female patients and also it was highly prevalent in the age group of 45-55 years (28.00%). Socioeconomic status showed that overall prevalence was found to be higher in middle class and upper class patients as because of the changing life style of middle class families. All patients having one or more diabetic risk factors i.e. age, family history, obesity, life style, stress, alcohol and smoking, showing 29.67% patients with single diabetic risk factor, 34.33% with two diabetic risk factors and 36.00% with three or more diabetic risk factors. Study also showed that 76.66% patients among males and 55.83% patients among females were taking medicines regularly. The non-compliance shown by study population could be the cause of poor therapeutic outcome in them. It was concluded from the study that a number of socio-economic and demographic variables influence the prevalence rates as well as treatment seeking behavior. It was also shown that higher prevalence rate of diabetes mellitus may be because of the presence of risk factors like age, family history, obesity, life style, stress, alcohol and smoking. A major educational effort is required to inform the diabetes patients about the risk factors and complications. To overcome the ever-rising problem of non-compliance, patient counseling needs to be encouraged among the diabetes patients.

Introduction

Diabetes mellitus (DM) is a group of chronic metabolic disorders characterized by a deficiency of insulin secretion and/or insulin effect, which causes hyperglycemia and is associated with abnormalities in carbohydrate, fat and protein metabolism; and results in chronic complications including microvascular, and macrovascular, and neuropathic disorders. Diabetes mellitus is the leading cause of blindness in adults aged 20 to 74 years and the leading contributor to development of end-stage renal disease. Type 1 diabetes mellitus - formerly known as insulin-dependent diabetes (IDDM), childhood diabetes, is characterized by loss of the insulin-producing beta cells of the islets of Langerhans of the pancreas leading to a deficiency of insulin. The principal treatment of type 1 diabetes, even from the earliest stages, is replacement of insulin. Without insulin, ketosis and diabetic ketoacidosis can develop and coma or death will result. Currently, type 1 diabetes can be treated only with insulin, with careful monitoring of blood glucose levels using blood testing monitors. Emphasis is also placed on lifestyle adjustments (diet and exercise). Type 1 treatment must be continued indefinitely. Treatment does not impair normal activities, if sufficient awareness, appropriate care, and discipline in testing and medication is taken. Type 2 diabetes mellitus - previously known as adult-onset diabetes, maturity-onset diabetes, or non-insulin-dependent diabetes mellitus (NIDDM) - is due to a combination of defective insulin secretion and defective responsiveness to insulin (often termed insulin resistance or reduced insulin sensitivity), almost certainly involving the insulin receptor in cell membranes. In early stages, the predominant abnormality is reduced insulin sensitivity, characterized by elevated levels of insulin in the blood.

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