The prevalence of DM and DR in the rural tribal population was lower than the national average but is emerging, and more than half of diabetics had uncontrolled DM, which needs improved awareness and accessibility to health care services for this underprivileged population.
Key Findings
Results
The prevalence of diabetes mellitus among rural-tribal people aged 50 years and older in Tapi district, western India, was 4.9%.
381 of 7835 examined participants had DM; "prevalence of DM (381/7835) was 4.9% (95% confidence interval (CI): 4.2-5.6)".
Standard RAAB methodology with a DR module was used, with 139 clusters of 60 people aged ≥50 years selected by cluster random sampling with probability proportionate to size.
7835 (93.9%) of 8344 eligible participants were examined.
DM was defined as known DM or random blood glucose (RBG) ≥200 mg/dL on a doorstep test.
Results
Nearly one-third of people with diabetes were previously undiagnosed and identified only through the spot blood glucose test.
68.5% (261/381) were known diabetics.
31.5% (120/381) were identified by spot RBG test.
Results
More than half of known diabetics had uncontrolled diabetes by random blood glucose.
55% (144/261) of known diabetics had RBG ≥200 mg/dL.
The authors conclude that more than half of diabetics had uncontrolled DM.
Results
Among people with diabetes, 16.3% had any diabetic retinopathy.
Prevalence of any DR was 16.3% (95% CI: 12.5 to 20.1).
All diabetics underwent dilated retinal examination and Scottish DR grading.
Results
Maculopathy and sight-threatening DR were present in a smaller proportion of diabetics.
Any maculopathy prevalence was 9.2% (95% CI: 6.2 to 12.2).
Sight-threatening DR prevalence was 2.1% (95% CI: 0.7 to 3.5).
Conclusions
DM and DR prevalence in this rural tribal population was lower than the national average but is described as emerging.
The authors call for improved awareness and accessibility to health care services for this underprivileged population.
Further studies are needed to establish predictors and causal relationships between DM/DR prevalence in rural-tribal populations.
What This Means
This survey looked at diabetes and diabetic eye disease in rural tribal communities in Tapi district, western India. Teams went door to door and examined nearly 7,800 people aged 50 and older. Diabetes was identified from a prior diagnosis or a random blood sugar of 200 mg/dL or higher, and everyone with diabetes had their eyes examined after pupil dilation.
About 4.9% of those examined had diabetes, lower than the national average in India. Almost a third of people with diabetes (31.5%) had not known they had it. Among those already diagnosed, 55% still had high blood sugar readings. Among people with diabetes, 16.3% had some diabetic retinopathy, 9.2% had maculopathy, and 2.1% had sight-threatening retinopathy.
This research suggests diabetes and its eye complications are emerging in this underserved population, and that many cases are undetected or poorly controlled. The authors point to a need for better awareness and access to health care. The study used a single random glucose test and could not identify the causes or predictors of diabetes and retinopathy, so further research is needed.
Gajiwala U, Shroff K, Pachchigar S, Patel D, Shamanna B. (2026). Rapid assessment of diabetes mellitus and diabetic retinopathy in the rural-tribal population of Tapi district of western India.. Indian journal of ophthalmology. https://doi.org/10.4103/IJO.IJO_632_26