Participatory Diabetes Prevention and Management Program in a Semi-Urban Village in India

Objective- The purpose of this study was to (1) assess the prevalence of diabetes and (2) to evaluate a 4-month community-based nonpharmacological lifestyle modification intervention to prevent/reduce the risk of developing diabetes and its complications in the semi-urban village of Kharakadi, in Gujarat, India.

Research Design and Methods- 801 respondents from the slum areas were provided educational intervention using ‘trained trainers'. Interventions included diet, physical activity and change in knowledge tailored to form culturally and linguistically appropriate health education messages. Due to illiteracy and low educational level of the respondents, health messages were tailored to reach the target audience through locally accepted ‘edutainment' and intra-competition channels. Pre- and post intervention parameters were compared to examine the prevalence of diabetes and pre-diabetes and the effectiveness of the education intervention.

Results - Overall the crude prevalence of diabetes among adults was 3.3% with 15.6% pre-diabetes in adults. Intervention significantly reduced fasting blood glucose levels as well as reduced obesity among individuals with diabetes. Significant improvements in knowledge of diabetes and cardiovascular disease risk factors were noted among all respondents. Dietary improvements included an increase in fiber and protein and reduction in fat and carbohydrates.

Conclusions- This is the first study in slum areas of north India to show the prevalence of diabetes and pre-diabetes. Educational intervention reduced obesity risk factors and improved diet in the target population and especially among individuals with diabetes.