2334-P: Multimorbidity among Individuals with Diabetes (MAID) in India: A State-Level Analysis of a National Study

Introduction and Objective: Despite the rapidly increasing burden of multimorbidity and diabetes in India, limited data are available on the statewide and regional burden of multimorbidity among individuals with diabetes (MAID). Methods: We used data from the Longitudinal Aging Study in India (LASI wave 1), a nationwide survey among adults aged ≥18 years (n=72,250) to examine the statewide and regional burden of MAID. For this analysis, we included 8714 individuals with chronic diseases. MAID was defined as the presence of self-reported diabetes mellitus with any ≥1 of the following self-reported conditions: hypertension, heart disease, cancer, chronic obstructive pulmonary disease, tuberculosis, thyroid disorders, stroke, hepatitis B, arthritis, dementia, depression, hearing disorder, hypercholesterolemia, and neuropsychiatric disorders. The state-wise and regional burden of MAID along with multimorbidity weighted index (MWI-additive model) was estimated. Results: The mean (SD) age was 60.5 years (±11.7), and 59.2% were women. The prevalence of MAID was 73.6% (95% CI: 72.0-75.1) and varied across states (61.9%-87.6%), with the highest in Jammu & Kashmir (87.6%, MWI: -6.3 (-6.8, -5.8), Karnataka (86.5%, MWI: -6.9 (-9.1, -4.7) and lowest in Chhattisgarh (61.9%, MWI: -4.82 (-5.11, -4.53). Individuals residing in the north (OR=1.40; 95% CI: [1.51, 1.71]), south (1.49[1.25-1.77]), east (1.44[1.18-1.75]), west (1.32 [1.08, 1.62]), and northeast regions (1.27 [1.01-1.60]) had significantly higher odds of MAID in comparison to residents of central region. Conclusion: The burden of MAID is very high with almost every second person with diabetes suffering from it. Health system strengthening, deploying integrated care models in primary care, is imperative to address it effectively and improve patient outcomes.