title: Prevalence and risk factors of diabetes in a large community-based study in North India: results from a STEPS survey in Punjab, India.
abstract: OBJECTIVE
  India is the diabetes capital with home to 69.1 million people with DM, the second highest number of cases after China. Recent epidemiological evidence indicates a rising DM epidemic across all classes, both affluent and the poor in India. This article reports on the prevalence of diabetes and pre-diabetes in the North Indian state of Punjab as part of a large household NCD Risk Factor Survey.
  
  
  METHODS
  A household NCD STEPS survey was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. All the subjects were administered the WHO STEPS questionnaire, anthropometric and blood pressure measurements. Every alternate respondent in the sample (n = 2499) was assayed for blood parameters.
  
  
  RESULTS
  Overall prevalence of DM among the study participants was found out to be 8.3% (95% CI 7.3-9.4%) whereas prevalence of prediabetes was 6.3% (5.4-7.3%). Age group (45-69 years), marital status, hypertension, obesity and family history of DM were found to be the risk factors significantly associated with DM. Out of all persons with DM, only 18% were known case of DM or on treatment, among whom only about one-third had controlled blood glucose status.
  
  
  CONCLUSIONS
  The study reported high prevalence of diabetes, especially of undiagnosed cases amongst the adult population, most of whom have uncontrolled blood sugar levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up.
authors.affiliation: International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi, India.
authors.forename: Jaya Prasad
authors.initials: JP
authors.lastname: Tripathy
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: J S
authors.initials: JS
authors.lastname: Thakur
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Gursimer
authors.initials: G
authors.lastname: Jeet
authors.affiliation: School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sohan
authors.initials: S
authors.lastname: Chawla
authors.affiliation: Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Arnab
authors.initials: A
authors.lastname: Pal
authors.affiliation: Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Prasad
authors.affiliation: Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Saran
keywords: Diabetes; Epidemiology; STEPS survey