ISSN: 0975-8585

Research Journal of Pharmaceutical, Biological and Chemical

Sciences

Assessment of Risk for Type 2 Diabetes Mellitus among Adolescents in A

Medical College.
Sindhu R, Vinay AV*, Vastrad BC.

Department of Physiology, PES Institute of Medical Science and Research, Kuppam, Andhra Pradesh, India.

ABSTRACT

India is second largest densely populated country in the world, and also expected to become the
diabetic capital of the world by 2025. Diabetes mellitus is one of the leading causes of morbidity and mortality
in developing countries. It’s an iceberg disease where more than 50% of people are unaware of their diabetic
status. In this study risk assessment of type 2 diabetes mellitus among first year medical students were done
using a simple Indian diabetes risk score (IDRS). More than one third of the study group population belonged
to Medium risk and high risk group. A positive correlation was demonstrated between body mass index and
waist circumference with p value of < 0.01
Keywords: Diabetes mellitus, IDRS

*Corresponding author

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INTRODUCTION

Type 2 diabetes mellitus are one of the most common non-communicable diseases prevalent in the
developing countries. It’s one of the leading causes for morbidity and mortality. The current prevalence of
diabetic patients is around 35 million and with current rising trend it’s expected to be around 80 million by
2030 [1-4]. Earlier diabetes was common in middle aged and elderly individuals, but now it’s been diagnosed in
all age groups, including children. Hence there is a need to sensitize the population from an early age regarding
diabetes mellitus and screening of diabetes [5]. Adolescence is a critical time for young people, as the sheer
amount of stress and responsibility in the competitive world for the success is high. These stressors are even
more in the medical students. Thus we intended to assess the risk of type 2 Diabetes in medical students. This
will help us to incorporate some of the lifestyle changes in risk population so as to have a healthier younger
generation.

MATERIALS AND METHODS

The cross sectional Study was done at PES institute of medical sciences and research (PESIMSR),
Kuppam, Andhra Pradesh. The study population included first year medical students studying at PESIMSR,
unwilling and a known case of type 2 diabetes mellitus students were excluded from the study.

There were 146 among 150 first year medical students studying at PESIMSR, satisfied the study
criterion. All subjects were assessed for IDRS (Indian diabetes risk score) developed by Dr Mohan and his
colleagues, it was a semi-structured questionnaire comprising of general information, family history of
diabetes and anthropometric measurements(6) Here subjects responded to three simple question regarding
age, physical activity level and family history of diabetes. And waist circumference was measured.
Anthropometric data like height in centimeters and weight in kilograms were measured using stadiometer and
electronic weighing scale respectively. Body mass index were calculated.

Statistical analysis

The data obtained was tabulated in excel sheet and were analyzed. The scoring was done according to
IDRS criterion (appendix-1).The subjects were scored with a minimum score of Zero and a maximum score of
one hundred. Depending upon the score obtained the subjects were divided into three category of diabetic
risk, Score ≤ 30 were low risk, score of 40-50 were medium risk, and a score ≥ 60 were high risk candidates for
diabetes. The correlation between various parameters and risk was assessed.

RESULTS AND DISCUSSIONS

146 subjects participated in the study among which 53 were males and 93 were females.

All students were below the age of 18 years. Among them 51 students had increased waist
circumference (table-1). 70 students did not have any physical activity (table-2). With respect to BMI 33
students were overweight and 54 were obese (table-3). 40 students had family history of diabetes (table-4). 46
students were at medium risk and 7 students were at high risk for diabetes (table-5). Mean ± standard
deviations of BMI and waist circumference of the subjects are 24.27 ± 4.29 and 79.16 ± 10.44 respectively. A
positive correlation was seen between the BMI and waist circumference, that is if BMI score increases by one
then the waist circumference increases by 0.857 centimeters with p ≤ 0.01. Other tables of relation has been
described in tables-6 to table-11

This study showed that more than one third of the study populations were at risk of diabetes mellitus.
That is 46 were at medium risk and 7 were at high risk. It was notable that 34 among 54 obese subjects were at
risk. 51 subjects had increased waist circumference among them 43 were at risk of diabetes. 29 out of 40
subjects were at risk that had family history of diabetes mellitus. Among 70 sedentary subjects 44 were at risk
of diabetes, and it was notable that 12 subjects involved in regular moderate degree of physical activity were
at low risk.

The data suggests that modifiable risk factor like BMI, Waist circumference and degree of physical
activity play a major role in causation of disease. Adolescence is critical ages during which indoctrinating good

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habits and life style modification can reap positive health benefits. Regular practices of yoga have produced an
increase in the lean body mass and decrease in the body fat percentage [6] which subsequently reduce the
BMI and waist circumference. Intake of food rich in fibers and reduction of high caloric food bring about
harmony in the physiological function of the body. Adolescent people are susceptible to smoking and alcohol
consumption driven by sheer curiosity and pleasure [7], which are again modifiable risk factors.

We can hope on addressing these issues of diabetes risk factors at adolescent age, can restrain the
increasing trend of diabetes and have a healthy younger generation.

Appendix-1

INDIAN DIABETES RISK SCORE

Name: Gender: male/ female

Date of Birth: / /19
Waist circumference:
Height: cms Weight: kgs

Particulars Score ✓ Here

Age
<35 years 0
35-49 years 20
≥ 50 years 30

Waist circumference
Waist < 80cm (female), <90 cm (male) 0
Waist ≥ 80-89cm (female), ≥ 90-99 cm (male) 10
Waist ≥ 90cm (female), ≥ 100 cm (male) 20

Physical activity
Vigorous exercise (regular) or strenuous (manual)
0
activity at home/work
Moderate exercise (regular) or moderate physical
10
activity at home / work
Mild exercise (regular) or mild physical
20
activity at home/ work
No exercise and sedentary activities at home/work 30

Family history of diabetes

No diabetes in parents 0
One parent has diabetes 10
Both parents have diabetes 20

Maximum score possible 100

Risk classification

Score Risk ✓
≤ 30 Low
40-50 Medium
≥ 60 High

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Table 1

Waist circumference Number Percent

NORMAL 95 65.1
INCREASED 51 34.9
Total 146 100

Table 2

Physical activity Number Percent

NO EXERCISE 70 47.9
MILD EXERCISE 64 43.8
MODERATE EXERCISE 12 8.2
Total 146 100

Table 3

BMI Number Percent

UNDER WEIGHT 6 4.1
NORMAL 53 36.3
OVER WEIGHT 33 22.6
OBESE 54 37
Total 146 100

Table 4

Family history Number Percent

NO PARENT DIABETIC 106 72.6
ONE PARENT DIABETIC 35 24
BOTH PARENT DIABETIC 5 3.4
Total 146 100

Table 5

Diabetic Risk Number Percent

LOW RISK 93 63.7
MEDIUM RISK 46 31.5
HIGH RISK 7 4.8
Total 146 100

Table 6: Relation between gender and BMI

BMI SCORE Total

GENDER UNDER WEIGHT NORMAL OVER WEIGHT OBESE
MALE 3 19 9 22 53
FEMALE 3 34 24 32 93
Total 6 53 33 54 146

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Table 7: Relation between gender and risk

RISK Total
GENDER LOW RISK MEDIUM RISK HIGH RISK
MALE 45 5 3 53
FEMALE 48 41 4 93
Total 93 46 7 146

Table 8: Relation between BMI and risk of diabetes

RISK Total
BMI SCORE LOW RISK MEDIUM RISK HIGH RISK
UNDER WEIGHT 5 1 0 6
NORMAL 45 8 0 53
OVER WEIGHT 23 10 0 33
OBESE 20 27 7 54
Total 93 46 7 146

Table 9: Relation between waist circumference and diabetes

RISK Total
WAIST CIRCUMFERENCE LOW RISK MEDIUM RISK HIGH RISK
NORMAL 85 10 0 95
INCREASED 8 36 7 51
Total 93 46 7 146

Table 10: Relation between physical activity and risk of diabetes

RISK Total
PHYSICAL ACITVITY LOW RISK MEDIUM RISK HIGH RISK
NO EXERCISE 26 38 6 70
MILD EXERCISE 55 8 1 64
MODERATE EXERCISE 12 0 0 12
Total 93 46 7 146

Table 11: Relation between family history of diabetes and risk of diabetes

RISK Total
FAMILY H/O DM LOW RISK MEDIUM RISK HIGH RISK
NO PARENT DIABETIC 82 24 0 106
ONE PARENT DIABETIC 11 19 5 35
BOTH PARENT DIABETIC 0 3 2 5
Total 93 46 7 146

CONCLUSION

Adolescent age group is vulnerable to risk of diabetes and can be controlled by adapting healthy
lifestyle.

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ACKNOWLEDGEMENT

We would like to acknowledge Dr Achuth KS, for his help during this study.

REFERENCES

[1] Park K. Park’s textbook of Preventive and Social Medicine. 22nd ed. Jabalpur: Banarasidas Bhanot
Publications; 2013.
[2] Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. J Phys Assoc India 2005; 53:759–63.
[3] Wild S, Roglic G, Green A, Sicree R, King H. Diabetes Care 2004;(27): 1047–53.
[4] Deepa M, Deepa R, Shanthirani C, Datta M, Unwin N, Kapur A, et al. Assoc Phys India 2005;(53): 283–
7.
[5] Kenneth C, Dorothy B, Michael G, Daniel H. Clin Diabetes 2005;(23): 181– 5.
[6] Sahay BK. JAPI 2007;(55):121-6
[7] Skinner T. C, Channon, S, Howells L. and McEvilley A. Diabetes During Adolescence, in Psychology in
Diabetes Care, (2000) John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846569.ch2

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