title: Diabetes screening and the distribution of blood glucose levels in rural areas of North India.
abstract: OBJECTIVE
  Genetics and environment have both been implicated in the exponential rise in the prevalence of diabetes mellitus that affects 65.1 million people, and leads to a mortality of 1 million people every year in India. This study was devised to obtain the trends of the distribution of blood glucose, and sociodemographic characteristics in rural areas of a North Indian state.
  
  
  METHODS
  A cross-sectional study was conducted at eight centers in five districts. A camp-based approach was followed in the diabetes screening conducted in rural areas. Blood glucose measurements were obtained after informed consent by trained staff using a reflectance photometer instrument. Descriptive statistics, distribution curves, log transformations, and tests for bimodality were obtained.
  
  
  RESULTS
  45,318 participants consisting of 44.4% males and 55.6% females were screened. Ages ranged from 18 to 98 years with the mean age of 39.9 ± 14.44 years. 86.5% were normal (random blood sugar [RBS] <140 mg/dl), 10.6% were prediabetic (RBS 140-200 mg/dl) and 2.9% were diabetic (RBS > 200 mg/dl). The median blood glucose level steadily rose with increasing age. The prediabetic to diabetic ratio was 4:1. The distribution curve of RBS was right skewed. A log transformation was applied, and bimodality was tested using the Hartigan's dip test. The dip statistic (D) was 0.0162 with a simulated P < 0.001.
  
  
  CONCLUSIONS
  Mass screening for diabetes provides benefits from a clinical standpoint by helping to estimate the prevalence (diabetes) and the hidden burden of the disease (prediabetes). Screening programs can strengthen healthcare system initiatives and reduce the growing burden of diabetes in India.
authors.affiliation: Department of Research, Catholic Health Association of India, Secunderabad, Telangana, India.
authors.forename: Tomi
authors.initials: T
authors.lastname: Thomas
authors.affiliation: Department of Research, Catholic Health Association of India, Secunderabad, Telangana, India.
authors.forename: Shalini
authors.initials: S
authors.lastname: Prabhata
authors.affiliation: Department of Research, Catholic Health Association of India, Secunderabad, Telangana, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Valsangkar
keywords: Blood glucose distribution; diabetes screening; rural