Metabolic Syndrome - A New Paradigm: Need for Capacity Building of Health Care Workers for Early Screening in the Rural Indian Population

Background: We continue to experience an inexorable transition from communicable to chronic non-communicable diseases (NCD), worldwide. This is especially true in India, where it appears that metabolic syndrome (MetS) is increasing in prevalence due to rapid economic growth, change in food intake and physical inactivity have lead to increase in MetS. However access to health service is poor in India and proper assessment for metabolic disease is often lacking. Accredited Social Health Activists(ASHA) are available throughout India for doing house to house assessment and providing health care, a potential solution for identifying people with abnormal metabolic factors. The aim of this study was to conduct capacity building of ASHA workers for screening of metabolic syndrome in rural India and identify people in rural India with features of MetS.   Methods: After obtaining approval from institutional ethics committee 300 ASHAs were trained under World Diabetes Foundation fundedproject (WDF15-941) about aspects ofMetS, diabetes mellitus and diabetic foot. Hand holding training activities were held for each ASHA intheir respective area of practice. This was conducted by project staffs. Participants over the ageof 30 years were screened for the presence of MetS. Random blood glucose (RBS), blood pressure, body mass index (BMI) and waist circumference were measured.   Results: A total of 38,346 people were screened for the presence of metabolic syndrome,of which13,911(36.3%) were found to have MetS of which 4200(35.9%) were male and 9,711(37.2%) were female. Those with type 2 diabetes mellitus(T2DM) 1,555(36.7%) also had MetS. Among 3 diagnostic criteria, waist circumference was the highest with 34.1%. Individual with impaired random glucose levels have 1.5 times more risk of developing metabolic syndrome adjusted for age and gender. Conclusion: In conclusion, MetS was present in 36.3% participants residing in rural part of Indiai.e one third of the population. Amongst people with T2DM 36.7% had MetS. The result suggest better screening and early identification of these people will help in proper treatment which might reduce the risk of cardiovascular diseases. Funding: The field screening was conducted as a part of ongoing project funded by World Diabetes Foundation WDF 15-941 “Diabetic Foot care: Stepping Ahead”. Declaration of Interest: The author(s) declare no potential conflict of interest with respect to the research, authorship, and/or publication of this article. Ethical Approval: The study was initiated after obtaining the approval from institutional research committee and institutional ethics committee (IEC 700/2015).