Rapid assessment of diabetes mellitus and diabetic retinopathy in the rural-tribal population of Tapi district of western India

BACKGROUND: The present study assessed the prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) in a rural-tribal population in western India. METHODS: The standard RAAB (Rapid Assessment of Avoidable Blindness) methodology with DR module was used in this survey. A total of 139 clusters of 60 people each aged ≥50 years were selected by cluster random sampling with probability proportionate to size. The participants were classified as having DM if they were known to have DM or if their random blood glucose (RBG) level was ≥200 mg/dL, detected by the test offered at the doorstep. Dilated retinal examination and Scottish DR grading were performed for all diabetics. RESULTS: In total, 7835 (93.9%) out of 8344 eligible participants were examined. The prevalence of DM (381/7835) was 4.9% (95% confidence interval (CI): 4.2-5.6). Of these, 68.5% (261/381) were known diabetics and 31.5% (120/381) were identified by spot RBG test. Fifty-five per cent (n = 144/261) of known diabetics had RBG ≥200 mg/dL. The prevalence of any DR, any maculopathy, and sight-threatening DR was 16.3% (95% CI: 12.5 to 20.1), 9.2% (95% CI: 6.2 to 12.2), and 2.1% (95% CI: 0.7 to 3.5), respectively. CONCLUSION: The prevalence of DM and DR in the rural tribal population was lower than the national average but is emerging. More than half of the diabetics had uncontrolled DM, which needs improved awareness and accessibility to health care services for this underprivileged population. Further studies are needed to establish predictors and causal relationship between prevalence of DM/DR in the rural-tribal population.