Department of Home Science, Banasthali Vidyapith, Jaipur, Rajasthan, India

^*Corresponding author: Mishra S, Department of Home Science, Banasthali Vidyapith, Jaipur, Rajasthan, India; E-mail: mshubhi709@gmail.com

Copyright: © 2022 Mishra S, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The global encumber of type 2 diabetes is escalating each day, and of those affected are still undiagnosed. Early screening of the disease may prove to be a life saver in overseeing the onset of disease. The Indian Diabetes Risk Score (IDRS) may accommodate in the screening of undiagnosed type 2 diabetes. IDRS is simple, less time consuming and economic. Early detection followed by educating population, lifestyle management and their implementation may lessen the overall lumber of disease type 2 diabetes worldwide.

Diabetes

Diabetes is a severe metabolic state that arises when the body’s insulin synthesis is disrupted or when the produced insulin is not used effectively. Type 2 diabetes, despite being entirely preventable, accounts for the significant number of diabetes cases [1]. The causes of type 2 diabetes are varying in person to person among population. It can be managed effectively by supporting, educating, and encouraging them to adopt a healthy lifestyle [2]. Although, there is a clear correlation between the type 2 diabetes, overweight, obese, ethnicity and having family history [3].

Type 1- An autoimmune reaction in which the body’s immune system targets the pancreas’ insulin-producing beta cells causes type 1 diabetes. As a result, the body produces very little or no insulin [2].

Type 2- Hyperglycaemia in type 2 diabetes is caused by the body’s cells’ failure to respond properly to insulin, a condition known as insulin resistance. Insulin resistance causes the hormone to become less effective, which leads to an increase in insulin production. Inadequate insulin production can develop over time as a result of the pancreatic beta cells’ inability to keep up with demand [3].

Diabetes is seen as a major public health issue as well as a global societal disaster. Diabetes affects 382 million individuals worldwide and this will increase to 592 million people by 2035 [4]. It has major consequences, with the quality of life decreasing. According to the World Health Organization (WHO), diabetes would likely rank seventh among leading causes of human mortality until 2030 and it has been identified as a major cause of premature death and illness around the world. During 2015, diabetes was found in 415 million people worldwide and estimated further increase of 642 million people among global population by 2040 [5]. The Diabetes Atlas data of the year 2016 comes from nations that account for more than 91.2 percent of the worldwide population. Type 2 diabetes is the most common type of diabetes, accounting for approximately 90% of all diabetes cases [1].

The ninth edition of International Diabetes Federation (IDF) 2019 estimated 463 million cases in the year 2019 and also estimated the total increase of 51% till the year 2030 [2]. Currently diabetes affected 537 million people globally. The prevalence of diabetes in adults aged 18-99 years was estimated to be 8.4% in 2017 and predicted to rise to 9.9% in 2045 [3].

Every fifth diabetic in the planet is an Indian [6]. In 2006, the International Diabetes Federation (IDF) predicted that the number of diabetic patients in India will climb to 69.9 million by 2025 unless effective preventative measures were adopted; nonetheless, India reached virtually that figure (69.1 million) in 2015 [5]. In 2021, India was placed second in the top ten nations or territories for the number of adults (20-79 years) with undiagnosed diabetes, trailed by China, Indonesia, and Pakistan. According to the report, there are 39.4 million (53.1%) people in India who have undiagnosed diabetes [3].

India has been dubbed the “Diabetic Capital of the World” due to its high diabetes incidence. Type 2 diabetes accounts for 85-95 percent of all diabetes cases, and the global epidemic of this illness is a major health-care burden [7].

India is the world’s diabetes capital, having the highest number of diabetic sufferers. In the population, there are a significant number of diabetic cases that are undiagnosed. Type 2 diabetes is caused by a diet heavy in fat, salt, and sugar, as well as a lack of physical activity. Other key factors that contribute to the development of type 2 diabetes include the subject’s family history. Lack of knowledge and understanding about the factors that cause disease increases the risk and leads to disease development [8].

Type 2 diabetes, despite being entirely avoidable, accounts for the great majority of diabetes cases [1]. Many people with type 2 diabetes are diagnosed after they have begun to experience symptoms. It’s delayed by the time people get know about the formerly developed type 2 diabetes in them. This state cannot be reversed it can only be managed by some lifestyle modifications. So, this state of affair can be prevented lone by early screening.

If early screening is done on time, the prevalence of type 2 diabetes will get significantly reduced. Early detection, understanding of relevant factors, and the implementation of preventative actions all collectively contribute towards prevention. As a result of early diagnosis, individuals are less likely to acquire type 2 diabetes. Ultimately, this approach may be conducive towards reducing the new cases. Early screening of diabetes may prevent or slow the development of complications if active treatment is implemented early [9].

Early screening can be boon in the prevention of type 2 diabetes as it may vigilant people by presenting the actual picture. Indian Diabetic Risk Score (IDRS) is a non invasive tool used for an early screening of type 2 diabetes. IDRS developed by Madras Diabetes Research Foundation (MDRS) for making screening programmes most cost effective [10]. There are plethora of researches and validations quoted in this article which proves that this tool is entirely fitting for the screening of the disease as it is simple, quick and less outlay.

The Indian Diabetic Risk Score is a simple method for detecting type 2 diabetes that hasn’t been diagnosed. This screening tool was created with simple characteristics in mind to determine the risk of type 2 diabetes in people of various ages. It is comprised of four simple parameters: (i) age, (ii) abdominal obesity (waist circumference), (iii) diabetes in the family, and (iv) Physical activity. The screening tool IDRS was created by MDRS to make screening programmes more cost effective [11].

A maximum score of 100 is given and subjects with an IDRS score of less than 30 were classified as low risk, those with a score of 30-50 as medium risk and those with a score of more than 60 as high risk for diabetes. This screening tool is totally non invasive, thrifty and less time consuming. Such tools are effective in unmasking the true extent of disease burden.

IDRS tool has been used by number of Indian researches to find out the risk of type 2 diabetes among different age groups. A study conducted on 1530 adult population for prediction of undiagnosed type 2 diabetes using IDRS. This screening by IDRS tool categorized study subjects into 3 categories i.e., low risk (70.4%), medium risk (19.5%) and high risk (10.1%) population [12]. Another assessed the risk of type 2 diabetes among rural population in Karnataka by using IDRS. According to IDRS in this study, 14.84% of the subjects falls under the category of high risk of type 2 diabetes, 73.19% covered under the moderate risk category and 11.95% were falling in the category of low/no risk of type 2 diabetes [13]. Likewise, one more performed screening for type 2 diabetes in Chennai and concluded that 18% of the study population had low risk, 45% subjects had medium risk and 37% of study population had high risk of developing type 2 diabetes [14].

Studies quoted in this article clearly evidenced that the Indian Diabetic Risk Score is a most suitable non-invasive tool for screening of type 2 diabetes. Studies indicate that IDRS screening tool used majorly among adult population of 20 to 40 years age group in both urban and rural areas. Studies concluded diverse results for each risk categorization given by IDRS i.e., category of high, moderate and low risk In a number of studies higher percentage falls under high risk and several studies revealed data shows higher percentage towards the category of medium or low risk [15-18] (Table 1-3 ).

Early detection is an imperative necessitate as it may be conducive towards the prevention process, furthermore delaying the onset of disease. Plethora of cases remains undiagnosed each year. Disease cannot be upturned it can merely be managed. IDRS is the most appropriate and uncomplicated community screening tool for screening the risk of type 2 diabetes. Screening procedures followed by implementation of edification will eventually result in decreasing the overall burden of disease across the globe.