Introduction non-communicable diseases (NCD, s) are one of the major challenges for public health not only in terms of human suffering bit also the harm they inflict on Socio-economic development.
Objectives:
Methodology: Cross-sectional observational study was done on 4075 patients/beneficiaries who attended different clinics of the department over a period of 2 years and were screened for HT, DM and obesity in the NCD awareness and screening clinic of department besides studying their socio-demographic and other factors. Data so collected was analysed using IBM-SPSS statistics version 20. Results: Out of total study participants 1630 (40%) were known hypertensive, 3445 population was screened for raised BP, amongst those 326 (9.4%) were found to have raised BP.Also among hypertensive, 801(49%) had raised BP at the time of screening. Likewise, among total population of 4075, 734(18%) were known diabetics. Among the rest 3341, 2205(66.9%) had blood sugar (R) <140mg/dl while Bl.sugar (R) was in range of 140-199 mg/dl in 825(24.6%) subjects and greater than 200mg/dl in 311(9.4%). Among the known diabetics,44(5.9%) had raised blood sugar at the time of screening. Conclusion: Screening has a paramount role in detecting the hidden burden of NCDs and should be advocated and implemented at all places at war footing in order to prevent long term complications of NCD’s.
Non-communicable diseases (NCDs) are responsible for approximately 74% of all global deaths and pose a significant threat to achieving Sustainable Development Goals (SDG) 3 & 4, which aim to reduce premature NCD-related mortality by one-third by 2030.¹·² In India, NCDs contribute to roughly 64% of total deaths, mirroring the global pattern.³ The diabetes burden in India is substantial, with recent estimates indicating over 212 million adults living with the disease—about one-quarter of the worldwide total.⁴·⁵ Additionally, hypertension affects an estimated 220–234 million adults in India, making it a major public health concern.⁶·⁷ As such, early detection and timely management of both diabetes and hypertension are essential to curb morbidity and premature mortality due to NCDs.⁸ Early identification and prompt management is the key to reduce morbidity and premature mortality due to NCDs. To achieve this, India launched the national programme for prevention and control of cancer, DM, cardiovascular diseases and stroke (NPCDCS) in 2010. Opportunistic screening for persons aged ≥30 years at all public health facilities from sub-centres (SCs), primary health centres (PHCs) and above is an integral strategy for early detection of DM and HTN under the NPCDCS. Realizing the growing burden of NCDs, associated morbidities and mortalities, Government of India has identified other priority NCD conditions beyond common NCDs and widened the ambit of the programme by including Chronic Obstructive Pulmonary Disease (COPD) and Asthma, Chronic Kidney Disease (CKD), Non-Alcoholic Fatty Liver Disease (NAFLD), Pradhan Mantri National Dialysis Programme (PMNDP). Hence, the NPCDCS is now renamed as NP-NCD.3Nevertheless, screening both opportunistic and population based continues to remain the main strategy to combat the epidemic.
Objectives:
It was a cross-sectional study done on individuals aged 30 years or above in the department of Community Medicine, SKIMS,Soura. The study subjects were 4075 patients/ beneficiaries who attended different clinics of the department over a period of 2 years (2020-2022) . All the people aged ≥ 30 years attending the different health clinics were screened for DM and HT. Weight, height, were also measured, and BMI was calculated besides studying their socio-demographic and other factors. Random Capillary Blood Glucose (RCBG) was used to screen for DM. Those with a blood glucose of more than 140 mg/dl. Random Capillary Blood Glucose (RCBG) was used to screen for DM. Those with a blood glucose of more than 140 mg/dl were sensitized about the risk of diabetes and were asked to attend the health center the next day for Fasting Plasma Glucose (FPG) after maintaining at least 8 h of fasting. RCBG and FPG were assessed using a glucometer by pricking the pulp of the left ring finger with a sterile lancet after applying the spirit swab. DM was diagnosed when a participant had an FPG level of ≥ 126 mg/dl. Prediabetes was diagnosed if the FPG value was 110–125 mg/dl [13].
Blood Pressure (BP) was measured using a digital blood pressure monitor. It was ensured that the participants had not consumed caffeine, tobacco, or exercised in the last 30 min, and that the patient has sat still for at least 5 min. To assess BP, the patients were asked to sit with their back straight, feet flat, and legs uncrossed with their arm on a flat surface at the heart level. Two blood pressure reading were taken at 1-min interval using a cuff of appropriate size. The average of the two readings was taken as the blood pressure reading of the participant. Hypertension was diagnosed using the Joint National Committee (JNC) VIII criteria [14]. Those with systolic BP ≥ 140 mmHg and/or diastolic ≥ 90 mmHg were diagnosed as person having hypertension.
Data so collected were analysed using ibm-spss statistics version 20.
Table 1 shows the general characteristics of the study population.4075 study subjects were almost uniformly distributed among different age groups. Majority were females, literate and urbanites. Majority lived in nuclear families, were non-smokers and lead a sedentary life style. There was a positive family history in majority.
Out of total study participants 1660 (40%) were known hypertensive, 2415 population was screened for raised BP, amongst those 326 (9.4%) were found to have raised BP. Also among hypertensive, 801(49%) had raised BP at the time of screening (Table 2). Likewise among total population of 4075, 734(18%) were known diabetics. Among the rest 3341, 2205(66.9%) had blood sugar (R) <140mg/dl while Bl.sugar (R) was in range of 140-199 mg/dl in 825(24.6%) subjects and greater than 200mg/dl in 311(9.4%).(Table 3)Among the known diabetics,44(5.9%) had raised blood sugar at the time of screening. Only 34.6% had normal BMI (Table 4). Table 5 depicts the association of BP levels with general characteristics.57.8% of subjects with raised BP were >60 year old, females, literate, smokers, lived in urban areas and lived a sedentary life. Some of these associations were statistically significant. Likewise Table 6 depicts association of blood sugar levels across general characteristics. Again raised Blood sugar levels were seen mainly in age group >60.No much difference was seen in other characteristics vis-à-vis raised Blood sugar levels. Majority of subjects with raised BMI were found in age-group 40-50, and in females, illiterates, non-smokers and in sedentary persons.
In our study 1660(40.7%) were known hypertensives.This high finding is almost consistent with two more studies 9,10,confirming the fact that prevalence of HT is high worldwide and thus makes a case for using all opportunities for screening people for hypertension so as to treat them earlier and thus reducing HT related complications, morbidity and mortality. The yield of newly diagnosed hypertensives in our study was 13.5% which is less than that found in yet other two studies where values were found to be 17.9% and 22.2% respectively11,12. The higher values in these studies may be due to the fact that lower age cut-off was used. In our study increasing age was found to be associated with HT which is consistent with some previous studies 13,14. There was not much gender difference with prevalence of high BP which is consistent with a study15. In our study smoking was higher among persons with raised BP as compared to those with normal BP which is similar to study by Anindo Majundar 11. Prevalence of smoking in our study is 17% which is similar to a study in rural Maharashtra16.
In the present study, 18% of participants were known diabetics, and 34% had random blood sugar (RBS) ≥ 140 mg/dL on screening, indicating a substantial reservoir of undiagnosed hyperglycemia. Similar regional findings reinforce the plausibility of these figures: Kalra et al. reported 32.4% of screened adults with random capillary blood glucose (RCBG) ≥ 140 mg/dL in opportunistic community screening in India 17; Paudel et al. observed 17.8% with RBS of 140–199 mg/dL and 4.4% with RBS ≥ 200 mg/dL in Nepal 18; Kaur et al. found 13.5% with RBS > 140 mg/dL among rural North Indians 19; and Sudharsanan et al. reported 20.4% above the 140 mg/dL threshold in a semi-urban South Indian cohort 20. The relative variation across these studies may reflect differences in population characteristics, urbanization trends, dietary habits, and obesity prevalence.
On a global scale, undiagnosed diabetes remains a major concern. The IDF Diabetes Atlas (2025) estimates that over 40% of adults with diabetes remain undiagnosed worldwide21. Moreover, regional analyses reveal that in South Asia, up to 66% of diabetes cases detected through screening were previously unrecognized22. These global figures echo the magnitude of undetected hyperglycemia observed in this study.Together, these findings underscore the critical importance of community-based blood sugar screening programs. Early detection—particularly using an easily deployable test like RBS—can bridge the diagnostic gap, enabling timely intervention and reducing the future burden of diabetes-related complications.The association of demographic and behavioural risk factors with diabetes revealed literacy levels, lack of physical activity and tobacco consumption were independent risk factors for diabetes while age was the only risk factor observed for age.
One important finding in our study was that ,almost half ( 49%) of known hypertensive had raised blood pressure and 5.9% of known diabetics had raised blood sugar at the time of study .This is still better compared to a study in Kinnaur HP, where only 20.3% of hypertensives and 8.5%of diabetics had their BP and blood sugar controlled23. Nevertheless there is a high need to identify the barriers in improving health seeking behaviour, early detection, treatment adherence,regular follow ups for effective control of both hypertension and diabetes.
In our study 40.6% and 23% were overweight and obese respectively which is much higher compared to study by Agarwal et.al.where only 18% and 3.2% of participants were overweight and obese respectively16. The higher proportions can be attributed to different criteria for BMI used in our study (Asian). However higher values similar to our study were also found in study by Oyeyene olinore24. Westernisation of diet and sedentary life style may be the reason for same as study subjects were mainly from urban area. Literacy status, physical inactivity and age was found to have association with BMI though all parameters were not statistically significant.Physical inactivity, increasing BMI, tobacco consumption are the modifiable risk factors which if taken care of will reduce the burden of both hypertension and diabetes.This calls for an urgent need of aggressive large scale community health educational activities for creating awareness about these health risk behaviours and their health consequences.There is also need for strict implementation of all guidelines laid down in NP-NCD program.Also screening guidelines should also take consideration of socio-demographic and economic factors which influence disease causation.
A comprehensive approach is needed to reduce the burden of ncds and risks associated with them, and to promote early identification and prompt management, robust screening can play a major role.
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