1186-P: Effectiveness of a Community-Based Approach Towards the Treatment and Prevention of Diabetes Mellitus in Rural India

Background: High rates of diabetes have been reported throughout urban India, though limited data exists concerning the prevalence of diabetes in rural areas, where 70% of the population resides. Socioeconomic and cultural differences may necessitate a different approach towards the treatment and prevention of diabetes in rural as opposed to urban areas.

Objective: The aim of this study was to evaluate the efficacy of a novel, community-centered model in rural villages of Hyderabad, India over the course of 6 months and compare results to traditional methods currently used by rural clinics in Ahmedabad, India.

Methods: As opposed to traditional methods that rely on direct patient-provider interaction, our community-centered method relied on a four-tier system consisting of providers, leaders of each village, “ambassadors” within each village, and patients. A total of 1,013 individuals aged ≥ 25 years (mean age 47.2 years) were sampled at random gender and age from 12 villages in Hyderabad and Ahmedabad. Vitals were taken and blood glucose was measured in all participants using a GlucoSpark glucometer. Baseline statistics were similar for both populations.

Results: In villages surrounding Hyderabad, the prevalence of diabetes was 9.6% (95% CI 7.2-11.9), of which 6.2% (5.1-7.3) were known cases and 3.4% (2.2-4.6) had not previously been diagnosed. The prevalence of diabetes in Ahmedabad was determined to be 12.9% (10.8-15.1), with 5.2% (3.8-6.6) diagnosed and 7.7% (6.2-8.2) previously undiagnosed. Notably, average glucose levels in the Hyderabad population were significantly lower than in the Ahmedabad population after 6 months (t=3.3, p<0.001).

Conclusion: While this study is not representative of rural India as a whole, it highlights the importance of community-centered health in rural settings. Findings suggest that approaches towards diabetes treatment, prevention, and education should vary with patient populations and be considered carefully.