The substantial suffering from diabetes can be prevented, but far too often the general population and their health care providers simply do not know how to do so. India - the country with the highest number of people living with diabetes in the world - is no exception. In order to prevent diabetes, people need basic information about healthy lifestyles and they need to be motivated to adopt such a lifestyle. It has been suggested that information technology such as mobile phones and the internet may be efficient means to motivate people to adopt and maintain a lifestyle with low dietary intake of fat and regular physical activity. This project will explore the benefits of using such technology to prevent diabetes amongst people at high risk. The aim of the project is to create awareness of diabetes and its prevention through the use of information technology (IT).
The project will be headed by the India Diabetes Research Foundation together with Prof. A. Ramachandran's Diabetes Hospitals in Chennai in Tamil Nadu. A group of scientists from India and United Kingdom will also contribute to the project with their expertise. In addition to the grant from WDF, the project has also received financial support from the British Council. Besides Chennai, the project will also be implemented in Mumbai and Pune in Maharashtra state. More specifically, the project will be implemented at the work sites of the Indian Railway Authority, which is one of the largest employers in the world, and the Electricity Board. All employees at the work sites will be informed via posters and pamphlets about the project and receive information about diabetes, its risk factors and the potential to prevent it. Those employees who already have diabetes will not participate in the project as they already have access to medical treatment through employer schemes. Those who have not been diagnosed with diabetes will complete the questionnaires to assess their risk of diabetes. If the result of the questionnaire indicates that they may be at risk of diabetes, they will be offered an oral glucose tolerance test to determine whether they have diabetes or not. It is expected that out of approximately 12,000 employees who will be reviewed by the questionnaire, 3,000 maybe at high risk of diabetes. Those who are found to have diabetes, but were unaware of this will be offered advice and referred to a physician for medial treatment and guidance. Those who have impaired glucose tolerance or impaired fasting glycaemia will enter the prevention project which is the core component of this project. The participants in the prevention project will randomly be assigned to either the intervention group or the control group. The intervention group will receive individualised feedback on lifestyle modification particularly diet and physical activity via their mobile phone or their home computer. In case the participants do not have a mobile phone they will be offered one so that they can receive and make phone calls and send SMS messages relevant to the project for free. Each week an SMS will be sent to the participants and phone calls will be made on a monthly basis. The focus of the messages and calls will be to motivate and discuss the progress and compliance with modification of target behaviour. It will also be possible for the participants to make phone calls to the investigators if necessary. The progress of the intervention group will be closely monitored every sixth month to detect changes in diet and physical activity. The control group on the other hand will receive standard lifestyle advice without the use of IT.They too will be monitored regularly. This way - by comparing the results of the intervention and control groups - it will be possible to assess whether intensive contact through IT such as mobile phones provide a greater success rate in implementing and maintaining desired behaviour change that can help prevent the onset of diabetes.
• 36,000 people were assessed for their risk of diabetes through questionnaires