LIFESTYLE MODIFICATIONS AMONG RURAL ELDERLY POPULATION OF PUNJAB: A BASELINE ASSESSMENT AND PLANNING FOR DIABETES COUNSELLING TRIALS

Background: Diabetes mellitus (T2DM) is a global public health problem with drastic increase in the number (above 382 million) leading to diabetes epidemic.1 Studies have recently confirmed rising prevalence rates among marginalized populations in rural India which has been ignored since long2. Moreover several cultural, socioeconomic and changing lifestyles appear to contribute to diabetes in rural regions of Northern India, highlighting the need to empower elderly to pursue health and well being on their own terms. Aim: Therefore the study was conducted to assess the baseline lifestyle modification among elderly population with diabetes mellitus type 2 patients residing in rural areas of district Ludhiana in order to plan for diabetic counselling trials. Methods: A study was conducted on 243 elderly subjects (>60 years) with diabetes mellitus type 2 living in selected village from Block Dehlon, district Ludhiana. Cluster random sampling technique was adopted to select the samples from villages. The data was collected by face to face interview method with the help of self structured checklist to assess lifestyle modifications on physical activity, diet, alcohol, smoking, stress management, personal care, treatment and health learning along with anthropometric measurements and blood glucose levels. Data collected by self report and bio-physiological methods. Results: Findings revealed that most of the elderly diabetics (67.13?6.82 years) were female, married, educated upto matric. Mean onset of DM type 2 was in 53.74?9.52 years with 13.06?7.41years of duration and treatment. 93.1% of the subjects presented with diabetes related complications with predominance of cardiovascular and retinopathy. Most of the subjects were overweight and at high risk of WC and WHR. Mean FBS (166.25?8.56), RBS (265.8?78.38) and Hb1Ac ( 7.98?0.79) were above normal range. Most subjects were following average 108(44.4%) to below average 100 (44.1%) lifestyle modification. Exercises were the least adopted lifestyle modification second by dietary. There was a significant association of lifestyle modification with age, educational status, duration of illness, lifestyle pattern and BMI at p<0.05. Lifestyle modification showed a significant effect of RBS (p=0.03) and occurance of diabetes related complications (p=0.00). Conclusion & recommendations: Elderly rural population suffering from diabetes has average to below average lifestyle modification. Good lifestyle modication improved anthropometric and blood sugar levels. Therefore community based interventions can encourage better lifestyle modification that could help in controlling sugar levels and hence reducing the number of complications among them.