Population based screening for diabetes: experience in Mumbai slums, Maharashtra, India

Background: The number of diabetic patients has increased over the years due to urbanization, high intake of unhealthy diet and a sedentary lifestyle. Majority remain undiagnosed as no systematic screening programme exists in the country. There is evidence that early diagnosis through simple screening test followed by confirmatory test can help to diagnose asymptomatic diabetics, thereby reducing or delaying the onset of complications. The programme aims for early diagnosis of diabetes through a population based screening programme.Methods: In the selected area, house-to-house visit was done to identify individuals aged 25 and above with and without diabetes. Those without a history of diabetes and consenting to participating were subjected to random capillary blood glucose testing. Those found to have raised blood glucose levels were further offered confirmatory testing at the urban health training centre or referred to their physician for further evaluation.Results: The participation rate for random capillary blood glucose testing in the community was very high. 70% of those available were tested using rapid blood glucose testing device. Amongst the 315 individuals tested, mainly women, 14% were found to have blood glucose levels above 140 mgs%. However the number of persons reporting for further evaluation was very poor. Only one person reported for further evaluation and was diagnosed as diabetic and inititated on treatment.Conclusions: Though it is possible through a population based screening programme to identify individuals with raised blood glucose levels, to what extent it will translate into early diagnosis of diabetes is uncertain.